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Austin G, Ferguson JJA, Eslick S, Oldmeadow C, Wood LG, Garg ML. Cardiovascular Disease Risk in Individuals Following Plant-Based Dietary Patterns Compared to Regular Meat-Eaters. Nutrients 2024; 16:1063. [PMID: 38613096 PMCID: PMC11013900 DOI: 10.3390/nu16071063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Plant-based diets (PBDs) have been associated with a lower risk of cardiovascular disease (CVD). The aim was to investigate the predicted 5-year and 10-year risk of developing CVD in individuals following PBDs compared to regular meat-eating diets. This cross-sectional study included n = 240 middle-aged adults habitually consuming dietary patterns for ≥6 months: vegan, lacto-ovo vegetarian (LOV), pesco-vegetarian (PV), semi-vegetarian (SV) or regular meat-eater (RME) (n = 48 per group). Predicted 5-year and 10-year CVD risks were quantified using the Framingham Risk Equation and the Australian Absolute CVD risk calculator, respectively. Multivariable regression analysis was used to adjust for age, sex, smoking status, physical activity, alcohol use and BMI. Over three-quarters of the participants were women, mean age of 53.8 yrs. After adjustments for potential confounders, there was no difference in the predicted risk of CVD between regular-meat diets and PBDs, although crude analyses revealed that vegans had a lower 5-year and 10-year predicted risk of CVD compared to RMEs. SVs, PVs and LOVs had lower CVD risk scores, however, not significantly. Vegans had a favourable cardiometabolic risk profile including significantly lower serum lipid levels, fasting blood glucose and dietary fats and higher dietary fibre intake compared to RMEs. This was the first study to purposefully sample Australians habitually following PBDs. We found that PBDs do not independently influence the predicted risk of CVD, although PBDs tended to have lower risk and vegans had significantly lower cardiometabolic risk factors for CVD.
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Affiliation(s)
- Grace Austin
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Jessica J. A. Ferguson
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Shaun Eslick
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Macquarie Medical School, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Lisa G. Wood
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Manohar L. Garg
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Macquarie Medical School, Macquarie University, Macquarie Park, NSW 2109, Australia
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2
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Goldman DM, Warbeck CB, Waterfall TJ, Sud A, Quarshie M, Craddock JC. Plant-based and Early Time-restricted Eating for Prevention and Treatment of Type 2 Diabetes in Adults: A Narrative Review. Can J Diabetes 2024:S1499-2671(24)00058-3. [PMID: 38513822 DOI: 10.1016/j.jcjd.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
Type 2 diabetes (T2D) is a significant public health challenge for which effective lifestyle interventions are needed. A growing body of evidence supports the use of both plant-based eating patterns and early time-restricted eating (eTRE) for the prevention and treatment of T2D, but research has not yet explored the potential of these dietary strategies in combination. In this narrative review we assessed the evidence by which plant-based diets, in conjunction with eTRE, could support T2D care. The electronic databases MEDLINE and the Web of Science were searched for relevant articles published throughout the last decade. Observational research has shown that healthy plant-based eating patterns and eTRE are associated with reductions in T2D risk. Interventional trials demonstrated that plant-based diets promote improvements in glycated hemoglobin, insulin resistance, glycemic control, and cardiometabolic risk factors. These changes may be mediated, in part, by reductions in oxidative stress, dietary acid load, and hepatocellular and intramyocellular lipids. The eTRE strategies were also shown to improve insulin resistance and glycemic control, and mechanisms of action included enhanced regulation of circadian rhythm and increased metabolic flexibility. Integrating these dietary strategies may produce additive benefits, mediated by reduced visceral adiposity and beneficial shifts in gut microbiota composition. However, potential barriers to concurrent implementation of these interventions may exist, including social challenges, scheduling constraints, and tolerance. Prospective trials are needed to examine their acceptability and clinical effects.
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Affiliation(s)
| | - Cassandra B Warbeck
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Adam Sud
- Plant-Based for Positive Change, Austin, Texas, United States
| | | | - Joel C Craddock
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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3
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Rosenau N, Neumann U, Hamblett S, Ellrott T. University Students as Change Agents for Health and Sustainability: A Pilot Study on the Effects of a Teaching Kitchen-Based Planetary Health Diet Curriculum. Nutrients 2024; 16:521. [PMID: 38398844 PMCID: PMC10892560 DOI: 10.3390/nu16040521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/27/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Global dietary habits are one of the main drivers of climate change. At the same time, they contribute to 11 million premature deaths every year. This raises the question of how the urgently needed transformation of food systems can be realized. Regardless of their degree paths, all university students, in their role as potential future experts and leaders in their fields, can serve as important change agents in society. In this paper, we (a) introduce a university curriculum in a teaching kitchen setting that is based on the planetary health diet (PHD) of the EAT-Lancet Commission, (b) investigate its feasibility, and (c) analyze its effects on the planetary health diet literacy of a pilot cohort of university students enrolled in various degree programs. We developed seven flipped classroom teaching kitchen sessions based on social cognitive theory (SCT), each consisting of a one-hour seminar with student presentations on various nutrition- and sustainability-related key topics, followed by corresponding two-hour hands-on cooking classes. To assess feasibility, specific questions from the official teaching evaluation of the University of Göttingen were analyzed. Changes in self-assessed planetary health diet literacy were measured using a pre- and post-survey. During the pilot phase, 26 students successfully completed the course. A total of 25 participants responded to the teaching evaluation and expressed high satisfaction with the course, the learning outcomes, and the level of demand. A total of 26 participants completed the pre- and post-survey. At the post-intervention, the students rated their planetary health diet literacy as 21 to 98% higher than before their course participation. The findings of this pilot study indicate that the curriculum was well-received and feasible with the target group, and they demonstrate that the course participation increased the university students' self-assessed ability to disseminate strategies for more sustainable and healthy diets. Through replication at other universities worldwide, the teaching kitchen-based planetary health diet curriculum might foster a social shift towards healthier and more climate-friendly food systems.
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Affiliation(s)
- Nicola Rosenau
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Centre, Humboldtallee 32, 37073 Göttingen, Germany
| | - Uwe Neumann
- Culinary Medicine Germany e.V., 48341 Altenberge, Germany;
| | - Stacey Hamblett
- The Teaching Kitchen Collaborative, 101 Middlesex Turnpike, Suite 6, Burlington, MA 01803, USA;
| | - Thomas Ellrott
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Centre, Humboldtallee 32, 37073 Göttingen, Germany
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4
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Soh BXP, Smith NW, R von Hurst P, McNabb WC. Evaluation of Protein Adequacy From Plant-Based Dietary Scenarios in Simulation Studies: A Narrative Review. J Nutr 2024; 154:300-313. [PMID: 38000662 DOI: 10.1016/j.tjnut.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/09/2023] [Accepted: 11/21/2023] [Indexed: 11/26/2023] Open
Abstract
Although a diet high in plant foods can provide beneficial nutritional outcomes, unbalanced and restrictive plant-based diets may cause nutrient deficiencies. Protein intake from these diets is widely discussed, but the comparison of animal and plant proteins often disregards amino acid composition and digestibility as measurements of protein quality. Poor provision of high-quality protein may result in adverse outcomes, especially for individuals with increased nutrient requirements. Several dietary modeling studies have examined protein adequacy when animal-sourced proteins are replaced with traditional and novel plant proteins, but no review consolidating these findings are available. This narrative review aimed to summarize the approaches of modeling studies for protein intake and protein quality when animal-sourced proteins are replaced with plant foods in diet simulations and examine how these factors vary across age groups. A total of 23 studies using dietary models to predict protein contribution from plant proteins were consolidated and categorized into the following themes-protein intake, protein quality, novel plant-based alternatives, and plant-based diets in special populations. Protein intake from plant-based diet simulations was lower than from diets with animal-sourced foods but met country-specific nutrient requirements. However, protein adequacy from some plant-sourced foods were not met for simulated diets of children and older adults. Reduced amino acid adequacy was observed with increasing intake of plant foods in some scenarios. Protein adequacy was generally dependent on the choice of substitution with legumes, nuts, and seeds providing greater protein intake and quality than cereals. Complete replacement of animal to plant-sourced foods reduced protein adequacy when compared with baseline diets and partial replacements.
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Affiliation(s)
- Bi Xue Patricia Soh
- Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Nick W Smith
- Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Pamela R von Hurst
- School of Sport Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Warren C McNabb
- Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand.
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Wathanavasin W, Kittiskulnam P, Johansen KL. Plant-based diets in patients with chronic kidney disease. ASIAN BIOMED 2024; 18:2-10. [PMID: 38515633 PMCID: PMC10954082 DOI: 10.2478/abm-2024-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Dietary protein restriction has been considered to be a nutritional-related strategy to reduce risk for end-stage kidney disease among patients with non-dialysis-dependent chronic kidney disease (CKD). However, there is insufficient evidence to recommend a particular type of protein to slow down the CKD progression. Recently, various plant-based diets could demonstrate some additional benefits such as a blood pressure-lowering effect, a reduction of metabolic acidosis as well as hyperphosphatemia, and gut-derived uremic toxins. Furthermore, the former concerns about the risk of undernutrition and hyperkalemia observed with plant-based diets may be inconsistent in real clinical practice. In this review, we summarize the current evidence of the proposed pleiotropic effects of plant-based diets and their associations with clinical outcomes among pre-dialysis CKD patients.
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Affiliation(s)
- Wannasit Wathanavasin
- Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok10330, Thailand
| | - Piyawan Kittiskulnam
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok10330, Thailand
- Division of Internal Medicine-Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok10330, Thailand
- Special Task Force for Activating Research in Renal Nutrition (Renal Nutrition Research Group), Office of Research Affairs, Chulalongkorn University, Bangkok10330, Thailand
| | - Kirsten L. Johansen
- Division of Nephrology, Hennepin Healthcare, Minneapolis, MN55415, USA
- Division of Nephrology, University of Minnesota, Minneapolis, MN55415, USA
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6
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Auyeskhan U, Azhbagambetov A, Sadykov T, Dairabayeva D, Talamona D, Chan MY. Reducing meat consumption in Central Asia through 3D printing of plant-based protein-enhanced alternatives-a mini review. Front Nutr 2024; 10:1308836. [PMID: 38299187 PMCID: PMC10827926 DOI: 10.3389/fnut.2023.1308836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/21/2023] [Indexed: 02/02/2024] Open
Abstract
3D food printing (3DFP) is emerging as a vital innovation in the food industry's pursuit of sustainability. 3DFP has evolved to significantly impact food production, offering the capability to create customized, nutritionally balanced foods. Central Asia has a higher than global average level of meat consumption per capita, which might be influenced by its historical and cultural background of nomadism. This dietary trend might potentially result in negative impacts on both the environment and human health outcomes, as it leads to increased greenhouse gas emissions and increased risk of chronic diseases. Reducing meat consumption holds the potential to address these sustainability and health issues. A possible strategy to reduce meat consumption and promote plant-based foods is 3D Food Printing (3DFP), which can rely on plant-protein sources from the region to create appealing and tasty alternatives for these populations. This review summarizes recent studies on plant protein-rich materials for 3DFP as a substitute to meet the growing global demand for meat as well as the 3DFP printing parameters associated with the different plant-based proteins currently used (e.g., lentils, soybeans, peas, and buckwheat). The findings revealed that buckwheat, a dietary staple in Central Asia, can be a promising choice for 3DFP technology due to its widespread consumption in the region, gluten-free nature, and highly nutritious profile.
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Affiliation(s)
- Ulanbek Auyeskhan
- Department of Mechanical & Aerospace Engineering, Nazarbayev University, Astana, Kazakhstan
- Department of Intelligent Systems & Cybersecurity, Astana IT University, Astana, Kazakhstan
| | - Arman Azhbagambetov
- Department of Mechanical & Aerospace Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Temirlan Sadykov
- Department of Mechanical & Aerospace Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Damira Dairabayeva
- Department of Mechanical & Aerospace Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Didier Talamona
- Department of Mechanical & Aerospace Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Mei-Yen Chan
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
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7
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Świątek M, Antosik A, Kochanowska D, Jeżowski P, Smarzyński K, Tomczak A, Kowalczewski PŁ. The potential for the use of leghemoglobin and plant ferritin as sources of iron. Open Life Sci 2023; 18:20220805. [PMID: 38152583 PMCID: PMC10751998 DOI: 10.1515/biol-2022-0805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 12/29/2023] Open
Abstract
Iron is an essential component for the body, but it is also a major cause for the development of many diseases such as cancer, cardiovascular diseases, and autoimmune diseases. It has been suggested that a diet rich in meat products, especially red meat and highly processed products, constitute a nutritional model that increases the risk of developing. In this context, it is indicated that people on an elimination diet (vegetarians and vegans) may be at risk of deficiencies in iron, because this micronutrient is found mainly in foods of animal origin and has lower bioavailability in plant foods. This article reviews the knowledge on the use of leghemoglobin and plant ferritin as sources of iron and discusses their potential for use in vegetarian and vegan diets.
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Affiliation(s)
- Michał Świątek
- Ekosystem-Nature’s Heritage Association, Institute of Microbial Technologies, Al. NSZZ Solidarność 9, 62-700Turek, Poland
| | - Adrianna Antosik
- Ekosystem-Nature’s Heritage Association, Institute of Microbial Technologies, Al. NSZZ Solidarność 9, 62-700Turek, Poland
| | - Dominika Kochanowska
- Ekosystem-Nature’s Heritage Association, Institute of Microbial Technologies, Al. NSZZ Solidarność 9, 62-700Turek, Poland
| | - Paweł Jeżowski
- Institute of Chemistry and Technical Electrochemistry, Poznan University of Technology, 4 Berdychowo St., 60-965Poznań, Poland
- InnPlantFood Research Group, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624Poznań, Poland
| | - Krzysztof Smarzyński
- InnPlantFood Research Group, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624Poznań, Poland
| | - Aneta Tomczak
- Department of Biochemistry and Food Analysis, Poznań University of Life Sciences, 48 Mazowiecka St., 60-623Poznań, Poland
| | - Przemysław Łukasz Kowalczewski
- InnPlantFood Research Group, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624Poznań, Poland
- Department of Food Technology of Plant Origin, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624Poznań, Poland
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8
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Davies KP, Gibney ER, O'Sullivan AM. Moving towards more sustainable diets: Is there potential for a personalised approach in practice? J Hum Nutr Diet 2023; 36:2256-2267. [PMID: 37545042 DOI: 10.1111/jhn.13218] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023]
Abstract
Discourse on the relationship between food production, healthy eating and sustainability has become increasingly prominent and controversial in recent years. Research groups often take one perspective when reporting on sustainable diets, and several often neglect considerations for the multiple aspects that make a diet truly sustainable, such as cultural acceptability, differences in nutritional requirements amongst the population and the efficiency of long-term dietary change. Plant-based diets are associated with lower greenhouse gas emissions (GHGEs) and have been linked with better health outcomes, including lower risk of diet-related chronic disease. However, foods associated with higher GHGE, such as lean red meat, fish and dairy, have beneficial nutritional profiles and contribute significantly to micronutrient intakes. Some research has shown that diets associated with lower GHGE can be less nutritionally adequate. Several countries now include sustainability recommendations in dietary guidelines but use vague language such as "increase" or "consume regularly" when referring to plant-based foods. General population-based nutrition advice has poor adherence and does not consider differences in nutritional needs. Although modelling studies show potential to significantly reduce environmental impact with dietary changes, personalising such dietary recommendations has not been studied. Adapting recommendations to the individual through reproducible methods of personalised nutrition has been shown to lead to more favourable and longer-lasting dietary changes compared to population-based nutrition advice. When considering sustainable healthy dietary guidelines, personalised feedback may increase the acceptability, effectiveness and nutritional adequacy of the diet. A personalised approach has the potential for delivering a new structure of more sustainable healthy food-based dietary guidelines. This review evaluates the potential to develop personalised sustainable healthy food-based dietary guidelines and discusses potential implications for policy and practice.
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Affiliation(s)
- Katie P Davies
- UCD Institute of Food and Health, School of Agriculture and Food Science, Dublin, Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, School of Agriculture and Food Science, Dublin, Ireland
| | - Aifric M O'Sullivan
- UCD Institute of Food and Health, School of Agriculture and Food Science, Dublin, Ireland
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9
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Viroli G, Kalmpourtzidou A, Cena H. Exploring Benefits and Barriers of Plant-Based Diets: Health, Environmental Impact, Food Accessibility and Acceptability. Nutrients 2023; 15:4723. [PMID: 38004117 PMCID: PMC10675717 DOI: 10.3390/nu15224723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/05/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Unhealthy dietary patterns are directly linked to the current Global Syndemic consisting of non-communicable diseases, undernutrition and climate change. The dietary shift towards healthier and more sustainable plant-based diets is essential. However, plant-based diets have wide intra differences; varying from vegan diets that totally exclude meat and animal products to traditional ones such as the Mediterranean diet and the new Nordic diet. It is acknowledged that plant-based diets may contribute simultaneously to improving population health as well as to decreasing the environmental impact of food systems. Evidence from cohort and randomized-controlled trials suggests that plant-based dietary patterns have beneficial effects on bodyweight control, cardiovascular health and diabetes prevention and treatment. On the other hand, micronutrient requirements may not be met, if some plant-based diets are not well-planned. Additionally, studies showed that lower consumption of meat and animal products results in lower environmental impacts. Consequently, plant-based diets could be a key factor to increase diet sustainability. This narrative review addresses the advantages of adherence to plant-based diets on human and planetary health considering strains and barriers to achieve this dietary transition, including cultural acceptability and affordability factors. Finally, potential intervention and policy recommendations are proposed, focusing on the update of current national food-based dietary guidelines.
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Affiliation(s)
- Giulia Viroli
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.K.); (H.C.)
| | - Aliki Kalmpourtzidou
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.K.); (H.C.)
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.K.); (H.C.)
- Clinical Nutrition Unit, General Medicine, ICS Maugeri IRCCS, 27100 Pavia, Italy
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10
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Rhee CM, Wang AYM, Biruete A, Kistler B, Kovesdy CP, Zarantonello D, Ko GJ, Piccoli GB, Garibotto G, Brunori G, Sumida K, Lambert K, Moore LW, Han SH, Narasaki Y, Kalantar-Zadeh K. Nutritional and Dietary Management of Chronic Kidney Disease Under Conservative and Preservative Kidney Care Without Dialysis. J Ren Nutr 2023; 33:S56-S66. [PMID: 37394104 PMCID: PMC10756934 DOI: 10.1053/j.jrn.2023.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/28/2023] [Accepted: 06/02/2023] [Indexed: 07/04/2023] Open
Abstract
While dialysis has been the prevailing treatment paradigm for patients with advanced chronic kidney disease (CKD), emphasis on conservative and preservative management in which dietary interventions are a major cornerstone have emerged. Based on high-quality evidence, international guidelines support the utilization of low-protein diets as an intervention to reduce CKD progression and mortality risk, although the precise thresholds (if any) for dietary protein intake vary across recommendations. There is also increasing evidence demonstrating that plant-dominant low-protein diets reduce the risk of developing incident CKD, CKD progression, and its related complications including cardiometabolic disease, metabolic acidosis, mineral and bone disorders, and uremic toxin generation. In this review, we discuss the premise for conservative and preservative dietary interventions, specific dietary approaches used in conservative and preservative care, potential benefits of a plant-dominant low-protein diet, and practical implementation of these nutritional strategies without dialysis.
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Affiliation(s)
- Connie M Rhee
- Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, California.
| | - Angela Yee-Moon Wang
- University Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
| | - Annabel Biruete
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana; Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Brandon Kistler
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Csaba P Kovesdy
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee; Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee
| | - Diana Zarantonello
- Nephrology and Dialysis Unit, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Gang Jee Ko
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | | | | | - Giuliano Brunori
- Nephrology and Dialysis Unit, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Keiichi Sumida
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Linda W Moore
- Department of Surgery, Houston Methodist Hospital, Houston, Texas
| | - Seung Hyeok Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoko Narasaki
- Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, California
| | - Kamyar Kalantar-Zadeh
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California; Nephrology Section, Tibor Rubin Veterans Affairs Medical Center, Long Beach, California
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11
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Kim SY, Kim M. What is on plates for school meals: focusing on animal- vs. plant-based protein foods. Nutr Res Pract 2023; 17:1028-1041. [PMID: 37780218 PMCID: PMC10522810 DOI: 10.4162/nrp.2023.17.5.1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/29/2023] [Accepted: 07/26/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to analyze the potential of school meals in South Korea as a sustainable tool to reduce carbon emissions by focusing on animal- vs. plant-based protein foods. MATERIALS/METHODS By using a stratified proportional allocation method, 536 out of the 11,082 schools nationwide were selected including 21 kindergartens, 287 elementary-, 120 middle- and 108 high schools. A total of 2,680 meals served for 5 consecutive days (June 21-25, 2021) were collected. We analyzed the average serving amounts of protein foods (animal- vs. plant-based) per meal and then, calculated the estimated average amounts of carbon emission equivalents per meal by applying the conversion coefficients. The t-test and analysis of variance were used for statistical analyses (α = 0.05). RESULTS The average serving amount of animal-based protein foods per meal was 12.5 g, which was approximately 3 times higher than that of plant-based ones (3.8 g) (P < 0.001); the Meat-group had the highest average amount of 17.0 g, followed by Egg-group (9.6 g), Fish-group (7.6 g), and Beans-and-Nuts-group (3.8 g) (P < 0.05). Specifically, pork (25.1 g) was ranked first, followed by poultry (19.6 g), processed meat products (18.0 g). The estimated average amount of carbon emission equivalents of animal-based protein foods per meal was 80.1 g CO2e, which was approximately 31 times higher than that of plant-based ones (2.6 g CO2e) (P < 0.001); the Meat-group had the highest average amount of 120.3 g CO2e, followed by Fish-group (44.5 g CO2e), Egg-group (25.9 g CO2e), and Beans-and-Nuts-group (2.6 g CO2e) (P < 0.05). Specifically, processed meat products (270.8 g CO2e) were ranked first, followed by pork (91.7 g CO2e), and processed fish products (86.6 g CO2e). CONCLUSIONS The results implied that school meals with plant-based alternatives could be a sustainable tool to improve carbon footprint.
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Affiliation(s)
- So-Young Kim
- Department of Food Science and Nutrition, Soonchunhyang University, Asan 31538, Korea
| | - Meeyoung Kim
- Department of Food and Nutrition, Kongju National University, Yesan 32439, Korea
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Mokhtari E, Rouhani P, Shahdadian F, Mohammadi S, Heidari Z, Saneei P. An Unhealthy Plant-Based Diet Increases Risk of Hypertension but not Framingham Risk Score in Adults. Curr Dev Nutr 2023; 7:102008. [PMID: 37869525 PMCID: PMC10587703 DOI: 10.1016/j.cdnut.2023.102008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/09/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Backgrounds We investigated the relation of plant-based diets (PDs) with hypertension (HTN) and Framingham risk score (FRS) in Iranian adults. Objectives We hypothesized that healthy PDs might have positive effects on blood pressure (BP) and FRS, whereas less-healthy plant-based foods might have negative effects. Methods The current cross-sectional study was performed on 527 middle-aged adults (45.7% women), who were selected through a multistage cluster random-sampling method. The assessment of dietary intakes was performed by using a validated food-frequency questionnaire. Twelve-hour fasting blood samples were collected to evaluate total cholesterol and high-density lipoprotein concentrations. BP was measured through the standard method and HTN was defined as BP ≥130/80 mmHg. FRS was used to predict the 10-y risk for development of cardiovascular disease (CVD). Results The prevalence of HTN and high FRS among study participants were, respectively, 62% and 15.6%. After adjustment for potential confounders, plant-based diet index (PDI) and healthy plant-based diet index (hPDI) were not significantly associated with HTN [odds ratio (OR): 0.99; 95% confidence interval (CI): 0.55, 1.79 and OR: 0.83; 95% CI: 0.45, 1.53, respectively)]. However, those in the highest tertile of unhealthy plant-based diet index (uPDI) in comparison with those in the bottom tertile had a 100% increased odds of HTN (OR: 2.00; 95% CI: 1.04, 3.88). Greater adherence to PDI, hPDI, and uPDI was not related to high FRS chance, in fully adjusted model (OR: 0.50; 95% CI: 0.15, 1.65; OR: 1.03; 95% CI: 0.26, 4.04; and OR: 2.05; 95% CI: 0.56, 7.52, respectively). Conclusions This study demonstrated that less-healthy PDs would enhance the chance of HTN in Iranian adults, although PDIs were not significantly related to the 10-y risk of developing CVD.
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Affiliation(s)
- Elahe Mokhtari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farnaz Shahdadian
- Department of Clinical Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sobhan Mohammadi
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Huang S, Riccardi D, Pflanzer S, Redwine LS, Gray HL, Carson TL, McDowell M, Thompson Z, Hubbard JJ, Pabbathi S. Survivors Overcoming and Achieving Resiliency (SOAR): Mindful Eating Practice for Breast Cancer Survivors in a Virtual Teaching Kitchen. Nutrients 2023; 15:4205. [PMID: 37836489 PMCID: PMC10574766 DOI: 10.3390/nu15194205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
The practice of mindful eating brings awareness to food choices, brings attention to the eating experience, and encourages selecting and preparing food that is both satisfying and nourishing. We examined mindful eating in breast cancer survivors following a 9-week, multidisciplinary virtual teaching kitchen intervention called Survivors Overcoming and Achieving Resiliency (SOAR). SOAR engaged participants through weekly cooking classes that also taught multiple domains of mindfulness. Participants (n = 102) were breast cancer survivors and completed the Mindful Eating Questionnaire (MEQ) prior to and after completion of the intervention. Linear regression analyses examined relationships between the aspects of mindful eating and body mass index (BMI). Wilcoxon (paired) rank sum tests evaluated the significance of the change in the MEQ total sum and subscales scores. A total of 102 participants completed both the pre- and post-intervention surveys. The mean change between the pre- and post-SOAR MEQ summary scores was 0.12 (sd = 0.30; Wilcoxon p-value = 0.0003). All MEQ subscale scores significantly increased with the exception of the distraction subscale. The MEQ summary scores increased for participants across both BMI stratifications. The SOAR teaching kitchen represents one of the first interventions that is tailored for breast cancer survivors and combines behavioral strategies from mindful eating training to nutritional knowledge and culinary medicine pedagogy in a virtual teaching kitchen. Further research is needed to examine whether mindful eating practices among cancer survivors result in sustainable healthy eating behaviors and food choices consistent with the cancer risk reduction guidelines.
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Affiliation(s)
- Sherri Huang
- Morsani College of Medicine, University of South Florida, Tampa, FL 33620, USA
| | - Diane Riccardi
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Sonya Pflanzer
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Laura S. Redwine
- Osher Center for Integrative Health, Department of Family Medicine and Community Health, Miller School of Medicine, University of Miami, Miami, FL 33134, USA
| | - Heewon L. Gray
- College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Tiffany L. Carson
- Department of Health Outcomes and Behavior, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Marc McDowell
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Zachary Thompson
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Jesse J. Hubbard
- Morsani College of Medicine, University of South Florida, Tampa, FL 33620, USA
| | - Smitha Pabbathi
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
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Martínez CF, Di Castelnuovo A, Costanzo S, Panzera T, Esposito S, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Bonaccio M. Pro-Vegetarian Food Patterns and Cancer Risk among Italians from the Moli-Sani Study Cohort. Nutrients 2023; 15:3976. [PMID: 37764762 PMCID: PMC10535500 DOI: 10.3390/nu15183976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Besides the Mediterranean diet, there is a paucity of studies examining plant-based diets in relation to cancer outcomes in Mediterranean populations. We analyzed 22,081 apparently cancer-free participants (mean age 55 ± 12 year) from the Moli-sani study (enrollment period 2005-2010; Italy). A general pro-vegetarian food pattern was computed by assigning positive or negative scores to plant- or animal-derived foods, respectively from a 188-item FFQ. A priori healthful or unhealthful pro-vegetarian food patterns distinguished between healthy plant foods (e.g., fruits, vegetables) and less-healthy plant foods (e.g., fruit juices, refined grains). Cancer incidence was defined as the earliest diagnosis of cancer from hospital discharge records over a median follow-up of 12.9 years. In multivariable-adjusted analyses, a general pro-vegetarian food pattern was associated with a lower rate of cancer incidence (HR = 0.85; 95%CI 0.75-0.97 for Q5 vs. Q1); no association was observed between the healthful or unhealthful pro-vegetarian food patterns and overall cancer incidence. A healthful pro-vegetarian pattern, however, was inversely associated with digestive cancer (HR = 0.76; 95%CI 0.58-0.99 for Q5 vs. Q1), while the unhealthful pro-vegetarian pattern was directly linked to respiratory cancer (HR = 1.68; 95%CI 1.06-2.68 for Q5 vs. Q1). Our findings in a Mediterranean population support the hypothesis that some, but not all pro-vegetarian diets, might prevent some cancers.
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Affiliation(s)
- Claudia Francisca Martínez
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
- Population Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | | | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
| | - Teresa Panzera
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
| | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (C.F.M.); (S.C.); (T.P.); (S.E.); (C.C.); (M.B.D.); (G.d.G.); (M.B.)
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Erratum: Plant to animal protein ratio in the diet: nutrient adequacy, long-term health and environmental pressure. Front Nutr 2023; 10:1281700. [PMID: 37727630 PMCID: PMC10505786 DOI: 10.3389/fnut.2023.1281700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 09/21/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fnut.2023.1178121.].
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McInnes C, Carstairs SA, Cecil JE. A qualitative study of young peoples' thoughts and attitudes to follow a more plant-based diet. Front Psychol 2023; 14:1196142. [PMID: 37727744 PMCID: PMC10506079 DOI: 10.3389/fpsyg.2023.1196142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/31/2023] [Indexed: 09/21/2023] Open
Abstract
Plant-based diets (PBDs) refer to dietary habits that reduce the consumption of animal-based products and increase the consumption of nutritionally rich plant foods. PBD's have been shown to provide significant health benefits, such as reducing obesity and improving psychological wellbeing, and are environmentally friendly. However, few studies have investigated factors that influence young people's thoughts and attitudes toward following a PBD in western societies, particularly in the United Kingdom. Understanding these factors may benefit public health interventions that encourage the consumption of more fruit and vegetables. The aim of this study was to explore the factors that affect young people's intentions toward following a PBD. Twenty-one young people (18-24 years) participated in this qualitative study. Participants were asked about their views of PBDs in a semi-structured interview. Thematic analysis was utilized to explore views and the barriers and facilitators to following a PBD. The Theory of Planned Behavior (TPB) was used as a framework to organise the findings. Within attitudes, the sub-themes identified were an awareness of a healthy diet, environmental concerns, health concerns and distrust, perceptions of PBDs and associated stereotypes, perceived restriction and lack of enjoyment, and need for education. Within subjective norms, the sub-themes identified were cultural and familial norms, peer influence, and exposure through social media. Within perceived behavioral control (PBC), the sub-themes identified were a lack of independence and parental control, lack of knowledge and perceived difficulty, lack of inclusiveness and accessibility, and inconvenience. Overall, the findings suggest that increased provision of education and knowledge about PBDs to young people, and widening access to PBDs, could encourage and help improve their understanding and intention to follow this dietary style. Tailored health promotion strategies, which also consider additional barriers and facilitators found within this study, could motivate young people to consume a more PBD.
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Affiliation(s)
- Catherine McInnes
- School of Medicine, University of St Andrews, St Andrews, Fife, Scotland, United Kingdom
| | - Sharon A. Carstairs
- School of Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Joanne E. Cecil
- School of Medicine, University of St Andrews, St Andrews, Fife, Scotland, United Kingdom
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Zhou Y, Xu P, Qin S, Zhu Y, Gu K. The associations between dietary flavonoid intake and the prevalence of diabetes mellitus: Data from the National Health and Nutrition Examination Survey 2007-2010 and 2017-2018. Front Endocrinol (Lausanne) 2023; 14:1250410. [PMID: 37664856 PMCID: PMC10474301 DOI: 10.3389/fendo.2023.1250410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/03/2023] [Indexed: 09/05/2023] Open
Abstract
Background Diabetes mellitus (DM) is a prominent health concern worldwide, leading to the high incidence of disability and mortality and bringing in heavy healthcare and social burden. Plant-based diets are reported associated with a reduction of DM risk. Plant-based diets are rich in flavonoids, which possess properties such as scavenging free radicals and exerting both anti-inflammatory and antioxidant effects. Purpose However, whether dietary flavonoids are associated with the prevalence of DM remains controversial. The potential reasons for contradictory epidemiological outcomes on the association between dietary flavonoids and DM prevalence have not been determined. Methods To address these limitations, we employed data from 22,481 participants in the National Health and Nutrition Examination Survey to explore the association between the intake of flavonoids and DM prevalence by weighted Logistic regression and weighted restricted cubic splines. Results We found that the prevalence of DM was inversely associated with the intake of total flavonoids in the second quartile [Odds Ratio (OR) 0.78 95% confidence interval (CI) (0.63, 0.97), p = 0.028], in the third quartile [0.76 (0.60, 0.97), p = 0.031], and in the fourth quartile [0.80 (0.65, 0.97), p = 0.027]. However, the p for trend was not significant [0.94 (0.88, 1.01), p = 0.096]. Moreover, the association between DM prevalence and the intake of total flavonoids was significantly influenced by race (p for interaction = 0.006). In Mexican Americans, there was a significant positive association between DM prevalence and total flavonoid intake within the third quartile [1.04 (1.02, 1.07), p = 0.003]. Total flavan-3-ol and subtotal catechin intake exhibited a non-linear U-shaped association with DM prevalence (p for non-linearity < 0.0001 and p for non-linearity < 0.0001, respectively). Compared to the first quartile of corresponding intakes, consumption within the third quartile of subtotal catechins [0.70 (0.55, 0.89), p = 0.005] and total flavan-3-ols [0.65 (0.50, 0.84), p = 0.002] was associated with a lower prevalence of DM. Conclusion Taken together, our study may provide preliminary research evidence for personalized improvement of dietary habits to reduce the prevalence of diabetes.
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Affiliation(s)
- Yanjun Zhou
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Peng Xu
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Shaolei Qin
- Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu, China
| | - Yan Zhu
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Ke Gu
- Department of Radiotherapy and Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
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Klein L, Dawczynski C, Schwarz M, Maares M, Kipp K, Haase H, Kipp AP. Selenium, Zinc, and Copper Status of Vegetarians and Vegans in Comparison to Omnivores in the Nutritional Evaluation (NuEva) Study. Nutrients 2023; 15:3538. [PMID: 37630729 PMCID: PMC10459941 DOI: 10.3390/nu15163538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Plant-based diets usually contain more nutrient-dense foods such as vegetables, legumes, whole grains, and fruits than a standard Western diet. Yet, the amount and especially the bioavailability of several nutrients, such as trace elements, is supposed to be lower in comparison to diets with consumption of animal-derived foods. Based on this, the Nutritional Evaluation (NuEva) study (172 participants) was initiated to compare the trace element status of omnivores, flexitarians, vegetarians, and vegans. Serum selenium, zinc, and copper concentrations and biomarkers were evaluated at baseline and during a 12-month intervention with energy- and nutrient-optimized menu plans. The implementation of optimized menu plans did not substantially influence the status of trace elements. At baseline, serum selenium biomarkers were lower in vegetarians and vegans compared to omnivores and flexitarians. The zinc intake of vegetarians and vegans was significantly lower compared to omnivores, whereas the Phytate Diet Score was increased. Accordingly, total serum zinc concentrations were reduced in vegans which was, however, only significant in women and was further supported by the analysis of free zinc. Regarding copper status, no differences were observed for total serum copper. Overall, we identified selenium and zinc as critical nutrients especially when maintaining a vegan diet.
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Affiliation(s)
- Lea Klein
- Institute of Nutritional Sciences, Friedrich Schiller University, 07743 Jena, Germany; (L.K.); (M.S.)
- Junior Research Group Nutritional Concepts, 07743 Jena, Germany
| | - Christine Dawczynski
- Institute of Nutritional Sciences, Friedrich Schiller University, 07743 Jena, Germany; (L.K.); (M.S.)
- Junior Research Group Nutritional Concepts, 07743 Jena, Germany
| | - Maria Schwarz
- Institute of Nutritional Sciences, Friedrich Schiller University, 07743 Jena, Germany; (L.K.); (M.S.)
- TraceAge—DFG Research Unit 2558, 07743 Potsdam-Berlin-Jena-Wuppertal, Germany; (M.M.); (H.H.)
| | - Maria Maares
- TraceAge—DFG Research Unit 2558, 07743 Potsdam-Berlin-Jena-Wuppertal, Germany; (M.M.); (H.H.)
- Department of Food Chemistry and Toxicology, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany
| | - Kristin Kipp
- Department for Pediatrics, Sophien- and Hufeland Klinikum, Hospital Weimar, 99425 Weimar, Germany;
| | - Hajo Haase
- TraceAge—DFG Research Unit 2558, 07743 Potsdam-Berlin-Jena-Wuppertal, Germany; (M.M.); (H.H.)
- Department of Food Chemistry and Toxicology, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany
| | - Anna P. Kipp
- Institute of Nutritional Sciences, Friedrich Schiller University, 07743 Jena, Germany; (L.K.); (M.S.)
- TraceAge—DFG Research Unit 2558, 07743 Potsdam-Berlin-Jena-Wuppertal, Germany; (M.M.); (H.H.)
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Kim J, Setiawan VW, Wilkens LR, Le Marchand L, Park SY. Healthful Plant-Based Dietary Pattern and Risk of Hepatocellular Carcinoma in a Multiethnic Population: A Cohort Study. Am J Clin Nutr 2023; 118:194-200. [PMID: 37121551 PMCID: PMC10447474 DOI: 10.1016/j.ajcnut.2023.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Plant-based dietary patterns assessed by a priori indices are associated with various health outcomes, but have rarely been examined in relation to liver cancer. OBJECTIVES This study investigated the associations between plant-based diets and risk of hepatocellular carcinoma (HCC) and evaluated whether the associations vary by sex and race and ethnicity. METHODS Data were from a total of 170,321 African American, Japanese American, Latino, Native Hawaiian, and White adults aged 45-75 y who completed a food frequency questionnaire in the Multiethnic Cohort Study. Cox models with adjustment for potential confounders were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for HCC according to 3 plant-based diet scores: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). RESULTS During a mean follow-up of 19.6 y, 722 incident HCC cases were identified. Multivariate-adjusted HR (95% CI) per 10-point increase was 0.82 (0.71-0.94) for PDI, 0.84 (0.74-0.96) for hPDI, and 1.08 (0.95-1.23) for uPDI. We found no significant differences by sex (all Pheterogeneity ≥ 0.53) or race and ethnicity (all Pheterogeneity ≥ 0.31). CONCLUSION Greater adherence to plant-based diets rich in healthy plant foods and low in less healthy plant foods is associated with a reduced risk of HCC in a multiethnic population.
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Affiliation(s)
- Jihye Kim
- Department of Genetics and Biotechnology, College of Life Science, Kyung Hee University, Yongin, South Korea.
| | - Veronica Wendy Setiawan
- Department of Population and Public Health Sciences, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, United States
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Song-Yi Park
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States
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Ferguson JJA, Austin G, Oldmeadow C, Garg ML. Plant-Based Dietary Patterns and Cardiovascular Disease Risk in Australians: Protocol for a Cross-Sectional Study. Nutrients 2023; 15:2850. [PMID: 37447176 DOI: 10.3390/nu15132850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Plant-based diets (PBDs) emphasise higher intakes of plant foods and lower intakes of animal foods, and they have been associated with reduced cardiovascular morbidity/mortality and lower cardiovascular disease (CVD) risk factors. Evidence is limited regarding the dietary profile, diet quality, and nutritional adequacy of PBDs, including their impact on CVD risk compared with traditional meat-eating diets in Australians. The PBD Study (PBDS) is a cross-sectional study that will recruit 240 adults from the Hunter region (NSW) without known CVD who are habitually consuming vegan (no animal flesh/animal products), lacto-ovo vegetarian (dairy and/or eggs only), pesco-vegetarian (fish/seafood only), or semi-vegetarian (minimal animal flesh) diets or are a regular meat-eater. To investigate dietary profile, diet quality, nutritional adequacy, and CVD risk, questionnaires (medical history, demographics, and physical activity), blood samples (biomarkers), physical measures (anthropometry, blood pressure, body composition, and bone density), and dietary intake (food frequency questionnaire and diet history) will be collected. One-way ANOVA and Kruskal-Wallis tests will compare the CVD risk and other quantitative measures, and Chi-square or Fisher's Exact tests will be used for qualitative data. Directed acyclic graphs will determine the confounding variables, and linear regression and mediation analyses will account for the confounders and estimate the effect of dietary patterns on CVD risk. p-values will be adjusted using the Benjamini-Hochberg method to control the False Discovery Rate to 5%.
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Affiliation(s)
- Jessica J A Ferguson
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
| | - Grace Austin
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW 2308, Australia
| | - Manohar L Garg
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
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Fouillet H, Dussiot A, Perraud E, Wang J, Huneau JF, Kesse-Guyot E, Mariotti F. Plant to animal protein ratio in the diet: nutrient adequacy, long-term health and environmental pressure. Front Nutr 2023; 10:1178121. [PMID: 37396122 PMCID: PMC10311446 DOI: 10.3389/fnut.2023.1178121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/18/2023] [Indexed: 07/04/2023] Open
Abstract
Background Animal and plant protein sources have contrasting relationships with nutrient adequacy and long-term health, and their adequate ratio is highly debated. Objective We aimed to explore how the percentage of plant protein in the diet (%PP) relates to nutrient adequacy and long-term health but also to environmental pressures, to determine the adequate and potentially optimal %PP values. Methods Observed diets were extracted from the dietary intakes of French adults (INCA3, n = 1,125). Using reference values for nutrients and disease burden risks for foods, we modeled diets with graded %PP values that simultaneously ensure nutrient adequacy, minimize long-term health risks and preserve at best dietary habits. This multi-criteria diet optimization was conducted in a hierarchical manner, giving priority to long-term health over diet proximity, under the constraints of ensuring nutrient adequacy and food cultural acceptability. We explored the tensions between objectives and identified the most critical nutrients and influential constraints by sensitivity analysis. Finally, environmental pressures related to the modeled diets were estimated using the AGRIBALYSE database. Results We find that nutrient-adequate diets must fall within the ~15-80% %PP range, a slightly wider range being nevertheless identifiable by waiving the food acceptability constraints. Fully healthy diets, also achieving the minimum-risk exposure levels for both unhealthy and healthy foods, must fall within the 25-70% %PP range. All of these healthy diets were very distant from current typical diet. Those with higher %PP had lower environmental impacts, notably on climate change and land use, while being as far from current diet. Conclusion There is no single optimal %PP value when considering only nutrition and health, but high %PP diets are more sustainable. For %PP > 80%, nutrient fortification/supplementation and/or new foods are required.
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Affiliation(s)
- Hélène Fouillet
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Alison Dussiot
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Elie Perraud
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Juhui Wang
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Jean-François Huneau
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, Inserm, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017, Bobigny, France
| | - François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
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Wu H, Gu Y, Meng G, Wu H, Zhang S, Wang X, Zhang J, Huang T, Niu K. Quality of plant-based diet and the risk of dementia and depression among middle-aged and older population. Age Ageing 2023; 52:7181249. [PMID: 37247402 DOI: 10.1093/ageing/afad070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND several previous studies have shown the importance of the plant-based diets. However, not all plant-based foods are necessarily beneficial for dementia or depression. This study aimed to prospectively investigate the association between an overall plant-based diet and the incidence of dementia or depression. METHODS we included 180,532 participants from the UK Biobank cohort study, free of a history of cardiovascular disease, cancer, dementia and depression at baseline. We calculated an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI) and an unhealthful plant-based diet index (uPDI) based on 17 major food groups from Oxford WebQ. Dementia and depression were evaluated using hospital inpatient records in UK Biobank. Cox proportional hazards regression models were used to estimate the association between PDIs and the incidence of dementia or depression. RESULTS during the follow-up, 1,428 dementia cases and 6,781 depression cases were documented. After adjusting for several potential confounders and comparing the highest with the lowest quintile of three plant-based diet indices, the multivariable hazard ratios (95% confidence intervals (CIs)) for dementia were 1.03 (0.87, 1.23) for PDI, 0.82 (0.68, 0.98) for hPDI and 1.29 (1.08, 1.53) for uPDI. The hazard ratios (95% CI) for depression were 1.06 (0.98, 1.14) for PDI, 0.92 (0.85, 0.99) for hPDI and 1.15 (1.07, 1.24) for uPDI. CONCLUSION a plant-based diet rich in healthier plant foods was associated with a lower risk of dementia and depression, whereas a plant-based diet that emphasises less-healthy plant foods was associated with a higher risk of dementia and depression.
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Affiliation(s)
- Hanzhang Wu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Ge Meng
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongmei Wu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shunming Zhang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuena Wang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Juanjuan Zhang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Kaijun Niu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
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Abstract
Recent advances in microbiome research have informed the potential role of the gut microbiota in the regulation of metabolic, cardiovascular, and renal systems, and, when altered, in the pathogenesis of various cardiometabolic disorders, including chronic kidney disease (CKD). The improved understanding of gut dysbiosis in cardiometabolic pathologies in turn has led to a vigorous quest for developing therapeutic strategies. These therapeutic strategies aim to investigate whether interventions targeting gut dysbiosis can shift the microbiota toward eubiosis and if these shifts, in turn, translate into improvements in (or prevention of) CKD and its related complications, such as premature cardiovascular disease. Existing evidence suggests that multiple interventions (eg, plant-based diets; prebiotic, probiotic, and synbiotic supplementation; constipation treatment; fecal microbiota transplantation; and intestinal dialysis) might result in favorable modulation of the gut microbiota in patients with CKD, and thereby potentially contribute to improving clinical outcomes in these patients. In this review, we summarize the current understanding of the characteristics and roles of the gut microbiota in CKD and discuss the potential of emerging gut microbiota-targeted interventions in the management of CKD.
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Affiliation(s)
- Keiichi Sumida
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN.
| | - Joseph F Pierre
- Department of Nutritional Sciences, College of Agriculture and Life Science, University of Wisconsin-Madison, Madison, WI
| | - Melana Yuzefpolskaya
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY
| | - Paolo C Colombo
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Csaba P Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN
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Carey CN, Paquette M, Sahye-Pudaruth S, Dadvar A, Dinh D, Khodabandehlou K, Liang F, Mishra E, Sidhu M, Brown R, Tandon S, Wanyan J, Bazinet RP, Hanley AJ, Malik V, Sievenpiper JL, Jenkins DJ. The Environmental Sustainability of Plant-Based Dietary Patterns: A Scoping Review. J Nutr 2023; 153:857-869. [PMID: 36809853 DOI: 10.1016/j.tjnut.2023.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 01/28/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A large part of the existential threat associated with climate change is the result of current human feeding patterns. Over the last decade, research evaluating the diet-related environmental impacts of plant-based diets has emerged, and a synthesis of the available data is now due. OBJECTIVES The objectives of the study were as follows: 1) to compile and summarize the literature on diet-related environmental impacts of plant-based dietary patterns; 2) to assess the nature of the data on impacts of plant-based dietary patterns on both environmental parameters and health (e.g., if land use is reduced for a particular diet, is cancer risk also reduced?); and 3) to determine where sufficient data exist for meta-analyses, in addition to identifying gaps within the literature. METHODS Global peer-reviewed studies on the environmental impacts of plant-based diets were searched in Ovid MEDLINE, EMBASE, and Web of Science. After removing duplicates, the screening identified 1553 records. After 2 stages of independent review by 2 reviewers, 65 records met the inclusion criteria and were eligible to be used in synthesis. RESULTS Evidence suggests that plant-based diets may offer lower greenhouse gas emissions (GHGEs), land use, and biodiversity loss than offered by standard diets; however, the impact on water and energy use may depend on the types of plant-based foods consumed. Further, the studies were consistent in demonstrating that plant-based dietary patterns that reduce diet-related mortality also promote environmental sustainability. CONCLUSIONS Overall, there was agreement across the studies regarding the impact of plant-based dietary patterns on GHGE, land used, and biodiversity loss despite varied plant-based diets assessed.
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Affiliation(s)
- Cassandra N Carey
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Melanie Paquette
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sandhya Sahye-Pudaruth
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Abolfazl Dadvar
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Dorothy Dinh
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Fred Liang
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Ekta Mishra
- McMaster University, Toronto, Ontario, Canada
| | - Mandeep Sidhu
- School of Global Health, York University, Toronto, Ontario, Canada
| | - Ramon Brown
- Department of Biology, Western University, Toronto, Ontario, Canada
| | - Shilpa Tandon
- Farncombe Family Digestive Health Research Institute, McMaster University, Toronto, Ontario, Canada
| | - Jessica Wanyan
- Department of Human Biology, University of Toronto, Toronto, Ontario, Canada
| | - Richard P Bazinet
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Vasanti Malik
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - David Ja Jenkins
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
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Filippin D, Sarni AR, Rizzo G, Baroni L. Environmental Impact of Two Plant-Based, Isocaloric and Isoproteic Diets: The Vegan Diet vs. the Mediterranean Diet. Int J Environ Res Public Health 2023; 20:ijerph20053797. [PMID: 36900805 PMCID: PMC10001513 DOI: 10.3390/ijerph20053797] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 06/12/2023]
Abstract
Food consumption is one of the major causes of climate change, resource depletion, loss of biodiversity, and other kinds of environmental impact by modern households. According to evidence, a global change in dietary habits could be the single most effective and rapid intervention to reduce anthropic pressure on the planet, especially with respect to climate change. Our study applied Life Cycle Assessment (LCA) to investigate the total environmental impact of two plant-based diets: the Mediterranean and the Vegan diets, according to relevant Italian nutritional recommendations. The two diets share the same macronutrient rates and cover all the nutritional recommendations. Calculations were made on the basis of a theoretical one-week 2000 kcal/day diet. According to our calculations, the Vegan diet showed about 44% less total environmental impact when compared to the Mediterranean diet, despite the fact that the content of animal products of the latter was low (with 10.6% of the total diet calories). This result clearly supports the concept that meat and dairy consumption plays a critical role, above all, in terms of damage to human health and ecosystems. Our study supports the thesis that even a minimal-to-moderate content of animal foods has a consistent impact on the environmental footprint of a diet, and their reduction can elicit significant ecological benefits.
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Affiliation(s)
- Denise Filippin
- Scientific Society for Vegetarian Nutrition, 30171 Venice, Italy
| | - Anna Rita Sarni
- Scientific Society for Vegetarian Nutrition, 30171 Venice, Italy
| | - Gianluca Rizzo
- Independent Researcher, Via Venezuela 66, 98121 Messina, Italy
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, 30171 Venice, Italy
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Zhang Y, Meng Y, Wang J. Higher Adherence to Plant-Based Diet Lowers Type 2 Diabetes Risk among High and Non-High Cardiovascular Risk Populations: A Cross-Sectional Study in Shanxi, China. Nutrients 2023; 15. [PMID: 36771492 DOI: 10.3390/nu15030786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
This study aimed to investigate the association between the plant-based diet index (PDI) score and T2D risk among residents of Shanxi Province, China, and explore whether the association was influenced by different levels of cardiovascular risk. A total of 50,694 participants aged 35-75 years were recruited between 2017 and 2019, and they were further divided into the high cardiovascular risk population (HCRP; n = 17,255) and the non-high cardiovascular risk population (non-HCRP; n = 33,439). The PDI was calculated based on food frequency from a food frequency questionnaire (FFQ). Incident T2D was defined based on elevated plasma glucose (≥7 mmol/L) or hypoglycemic medicine use. We investigated the association of the PDI andT2D risk using a two-level generalized estimating equation and restricted cubic splines model. The results showed that quartile 4 of the PDI indicated significantly reduced T2D risk in the total population (OR: 0.83; 95% CI: 0.75-0.92), HCRP (OR: 0.80; 95% CI: 0.71-0.91), and non-HCRP (OR: 0.80; 95% CI: 0.74-0.87) compared with corresponding quartile 1 (OR = 1). In stratified analysis, the negative associations between PDI and T2D risk were stronger in the total population with the elderly (age > 60 years), BMI < 24, and men, and in the non-HCRP with men and BMI 24-28, and in the HCRP with the elderly and BMI < 24 than those with corresponding subgroups (pinteraction < 0.05). Linear curves were observed for the total population and non-HCRP, but an L-shaped association was observed for the HCRP. Therefore, our results suggest that higher PDI scores may effectively attenuate the T2D risk in the Chinese population and non-HCRP, and a beneficial association of PDI with T2D risk was observed in the HCRP at a certain threshold level. Longitudinal studies and intervention trials are required to validate our study findings.
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Zhong GC, Li Z, You AJ, Zhu Q, Wang CR, Yang PF. Plant-based diets and the risk of pancreatic cancer: a large prospective multicenter study. Am J Clin Nutr 2023; 117:235-242. [PMID: 36863825 DOI: 10.1016/j.ajcnut.2022.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Plant-based diets have been recommended for improving health outcomes, including cancer. However, previous studies on plant-based diets and the risk of pancreatic cancer are scarce and fail to consider plant food quality. OBJECTIVES We sought to examine the potential associations of 3 plant-based diet indices (PDIs) with the risk of pancreatic cancer in a US population. METHODS A population-based cohort of 101,748 US adults was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The overall PDI, healthful PDI (hPDI), and unhealthful PDI (uPDI) were constructed to qualify adherence to overall, healthy, and less healthy plant-based diets, respectively, with higher scores indicating better adherence. Multivariable Cox regression was used to compute hazard ratios (HRs) for pancreatic cancer incidence. Subgroup analysis was conducted to identify the potential effect modifiers. RESULTS Over a mean follow-up of 8.86 years, 421 pancreatic cancer cases occurred. Participants in the highest compared with the lowest quartiles of overall PDI had a lower risk of pancreatic cancer [HRquartile 4 versus 1: 0.74; 95% confidence interval (CI): 0.57, 0.96; Ptrend = 0.023]. A stronger inverse association was observed for hPDI (HRquartile 4 versus 1: 0.56; 95% CI: 0.42, 0.75; Ptrend < 0.001). Conversely, uPDI was positively associated with the risk of pancreatic cancer (HRquartile 4 versus 1: 1.38; 95% CI: 1.02, 1.85; Ptrend = 0.012). Subgroup analyses revealed a stronger positive association for uPDI in participants with BMI <25 (HRquartile 4 versus 1: 3.22; 95% CI: 1.56, 6.65) than in those with BMI ≥25 (HRquartile 4 versus 1: 1.08; 95% CI: 0.78, 1.51) (Pinteraction = 0.001). CONCLUSIONS In this US population, adherence to a healthy plant-based diet confers a lower risk of pancreatic cancer, whereas adherence to a less healthy plant-based diet confers a higher risk. These findings highlight the importance of considering plant food quality in preventing pancreatic cancer.
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Affiliation(s)
- Guo-Chao Zhong
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Zhi Li
- Department of Breast and Thyroid Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ai-Jing You
- The Second Student Office, the Second College of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Qian Zhu
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Chun-Rui Wang
- Department of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng-Fei Yang
- Department of Nephrology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Njike VY, Kela GCM, Treu JA, Ayettey RG, Kussaga FM, Khan N, Comerford B, Agboola O. Egg Consumption in the Context of Plant-Based Diets and Diet Quality in Adults at Risk for Type 2 Diabetes: A Randomized Single Blind Cross-over Controlled Trial. J Am Nutr Assoc 2023; 42:130-139. [PMID: 35512755 DOI: 10.1080/07315724.2021.2006824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Lifestyle changes that emphasis on plant-based diets (PBD) are typically recommended for those at risk for type 2 diabetes mellitus (T2DM) to mitigate their cardo-metabolic risk. We examined the impact of the inclusion of eggs compared with their exclusion from PBD on diet quality among adults at risk for T2DM. This was a randomized, controlled, single-blind, crossover trial of 35 adults (mean age 60.7 years; 25 women, 10 men; 34 Caucasians, 1 African-American) at risk for T2DM (i.e., pre- diabetes or metabolic syndrome) assigned to one of two possible sequence permutations of two treatments (PBD with eggs and exclusively PBD), with a 4-week washout period. Participants received dietary counseling from a dietitian to exclude or to include 2 eggs daily in the context of PBD for a 6-week period. Diet quality was assessed using the Healthy Eating Index 2015 (HEI-2015) at baseline and 6 weeks. Compared with the exclusion of eggs, the inclusion of eggs in the context of PBD improved the diet quality score for intake of total protein foods (1.0 ± 1.1 vs. -0.4 ± 1.0; p <.0001); seafood and plant proteins (0.2 ± 1.2 vs. -0.4 ± 1.1; p = 0.0338); and fatty acids (0.8 ± 2.5 vs. -0.7 ± 2.7; p = 0.0260). Overall diet quality score depreciated with the adoption of exclusively PBD without eggs (-3.1 ± 8.3; p = 0.0411), while it was unaffected with the adoption of a PBD with the inclusion of eggs (-0.6 ± 7.9; p = 0.6892). Eggs could be used as an adjuvant to enhance the diet quality among those at risk for T2DM who adopt plant-based dietary patterns.
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Affiliation(s)
- Valentine Y Njike
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | | | - Judith A Treu
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Rockiy G Ayettey
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | | | - Nisar Khan
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Beth Comerford
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Olayinka Agboola
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
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Acito M, Fatigoni C, Villarini M, Moretti M. Effect of Cooking and Domestic Storage on the Antioxidant Activity of Lenticchia di Castelluccio di Norcia, an Italian PGI Lentil Landrace. Int J Environ Res Public Health 2023; 20:2585. [PMID: 36767948 PMCID: PMC9916172 DOI: 10.3390/ijerph20032585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
The aim of this work was to characterise Lenticchia di Castelluccio di Norcia (an Italian PGI lentil landrace) and assess the impact of cooking and storage on antioxidant activity. After opening the package (T0), samples were analysed using a set of chemical assays (i.e., total phenolic content, DPPH, ABTS, and ORAC assays). Analyses were also conducted on boiled, pressure-cooked, and 6-month-stored (T1) products. At both T0 and T1, raw Lenticchia di Castelluccio di Norcia PGI showed higher total phenolic content (T0: 9.08 mg GAE/g, T1: 7.76 mg GAE/g) and antioxidant activity (DPPH T0: 33.02 µmol TE/g, T1: 29.23 µmol TE/g; ABTS T0: 32.12 µmol CE/g, T1: 31.77 µmol CE/g; ORAC T0: 3.58 μmol TE/g, T1: 3.60 μmol TE/g) than boiled and pressure-cooked samples. Overall, pressure-cooking led to a smaller decline in total phenolic content and antioxidant activity than the common boiling procedure. Domestic storage led to a significant reduction in total phenolic content-both in raw and cooked products-but not in antioxidant activity. In summary, these results highlighted interesting amounts of phenols and antioxidant properties of this product, showing the impact of routine procedures. Given the relevance of pulses as sustainable plant-based meat alternatives and their importance in the prevention of non-communicable diseases, health professionals should consider these aspects in the context of correct nutrition education and scientific communication.
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Domínguez-Oliva A, Mota-Rojas D, Semendric I, Whittaker AL. The Impact of Vegan Diets on Indicators of Health in Dogs and Cats: A Systematic Review. Vet Sci 2023; 10. [PMID: 36669053 DOI: 10.3390/vetsci10010052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
There has been an increase in vegetarianism and veganism in human populations. This trend also appears to be occurring in companion animals, with guardians preferring to feed their animals in accordance with their own dietary values and choices. However, there has been controversy amongst vets and online commentators about the safety of feeding vegan diets to carnivorous species, such as cats and dogs. In spite of this controversy, to date there has been no systematic evaluation of the evidence on this topic. A systematic search of Medline, Scopus, and Web of Science was performed, identifying 16 studies on the impact of vegan diets on cat and dog health. Studies were appraised for quality using established critical appraisal tools or reporting guidelines. There was considerable heterogeneity in the outcomes measured, and study designs employed, with few studies evaluating key outcomes of interest. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was utilized for assessment of certainty in the evidence, with the evidence for most outcomes being assessed as low or very low. Whilst the quality and amount of evidence needs to be considered in formulating recommendations, there was no overwhelming evidence of adverse effects arising from use of these diets and there was some evidence of benefits. It is, however, recommended that future high-quality studies, with standardized outcome measures and large sample sizes, be conducted. At the current time, if guardians wish to feed their companion animals vegan diets, a cautious approach should be taken using commercially produced diets which have been formulated considering the nutritional needs of the target species.
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Holhorea PG, Felip A, Calduch-Giner JÀ, Afonso JM, Pérez-Sánchez J. Use of male-to-female sex reversal as a welfare scoring system in the protandrous farmed gilthead sea bream ( Sparus aurata). Front Vet Sci 2023; 9:1083255. [PMID: 36699328 PMCID: PMC9868933 DOI: 10.3389/fvets.2022.1083255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
Gilthead sea bream is a highly cultured marine fish throughout the Mediterranean area, but new and strict criteria of welfare are needed to assure that the intensification of production has no negative effects on animal farming. Most welfare indicators are specific to a given phase of the production cycle, but others such as the timing of puberty and/or sex reversal are of retrospective value. This is of particular relevance in the protandrous gilthead sea bream, in which the sex ratio is highly regulated at the nutritional level. Social and environmental factors (e.g., contaminant loads) also alter the sex ratio, but the contribution of the genetic component remains unclear. To assess this complex issue, five gilthead sea bream families representative of slow/intermediate/fast growth were grown out with control or a plant-based diet in a common garden system from early life to the completion of their sexual maturity in 3-year-old fish. The plant-based diet highly enhanced the male-to-female sex reversal. This occurred in parallel with the progressive impairment of growth performance, which was indicative of changes in nutrient requirements as the result of the different energy demands for growth and reproduction through development. The effect of a different nutritional and genetic background on the reproductive performance was also assessed by measurements of circulating levels of sex steroids during the two consecutive spawning seasons, varying plasma levels of 17β-estradiol (E2) and 11-ketotestosterone (11-KT) with age, gender, diet, and genetic background. Principal component analysis (PCA) of 3-year-old fish displayed a gradual increase of the E2/11-KT ratio from males to females with the improvement of nutritional/genetic background. Altogether, these results support the use of a reproductive tract scoring system for leading farmed fish toward their optimum welfare condition, contributing to improving the productivity of the current gilthead sea bream livestock.
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Affiliation(s)
- Paul G Holhorea
- Nutrigenomics and Fish Growth Endocrinology Group, Institute of Aquaculture Torre de la Sal, CSIC, Castellón, Spain
| | - Alicia Felip
- Group of Fish Reproductive Physiology, Institute of Aquaculture Torre de la Sal, CSIC, Castellón, Spain
| | - Josep À Calduch-Giner
- Nutrigenomics and Fish Growth Endocrinology Group, Institute of Aquaculture Torre de la Sal, CSIC, Castellón, Spain
| | - Juan Manuel Afonso
- Aquaculture Research Group, Institute of Sustainable Aquaculture and Marine Ecosystems (IU-ECOAQUA), University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Jaume Pérez-Sánchez
- Nutrigenomics and Fish Growth Endocrinology Group, Institute of Aquaculture Torre de la Sal, CSIC, Castellón, Spain
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Kesse-Guyot E, Allès B, Brunin J, Fouillet H, Dussiot A, Mariotti F, Langevin B, Berthy F, Touvier M, Julia C, Hercberg S, Lairon D, Barbier C, Couturier C, Pointereau P, Baudry J. Nutritionally adequate and environmentally respectful diets are possible for different diet groups: an optimized study from the NutriNet-Santé cohort. Am J Clin Nutr 2022; 116:1621-1633. [PMID: 36124645 DOI: 10.1093/ajcn/nqac253] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/12/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Research has shown that vegetarian diets have a low environmental impact, but few studies have examined the environmental impacts and nutritional adequacy of these diets together, even though vegetarian diets can lead to nutritional issues. OBJECTIVES Our objective was to optimize and compare 6 types of diets with varying degrees of plant foods (lacto-, ovolacto-, and pescovegetarian diets and diets with low, medium, and high meat content) under nutritional constraints. METHODS Consumption data in 30,000 participants were derived from the French NutriNet-Santé cohort using an FFQ. Diets were optimized by a nonlinear algorithm minimizing the diet deviation while meeting multiple constraints at both the individual and population levels: nonincrease of the cost and environmental impacts (as partial ReCiPe accounting for greenhouse gas emissions, cumulative energy demand, and land occupation, distinguishing production methods: organic and conventional), under epidemiologic, nutritional (based on nutrient reference values), and acceptability (according to the diet type) constraints. RESULTS Optimized diets were successfully identified for each diet type, except that it was impossible to meet the EPA (20:5n-3) + DHA (22:6n-3) requirements in lacto- and ovolactovegetarians. In all cases, meat consumption was redistributed or reduced and the consumption of legumes (including soy-based products), whole grains, and vegetables were increased, whereas some food groups, such as potatoes, fruit juices, and alcoholic beverages, were entirely removed from the diets. The lower environmental impacts (as well as individual indicators) observed for vegetarians could be attained even when nutritional references were reached except for long-chain n-3 (omega-3) fatty acids. CONCLUSIONS A low-meat diet could be considered as a target for the general population in the context of sustainable transitions, although all diets tested can be overall nutritionally adequate (except for n-3 fatty acids) when planned appropriately.This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-Paris Cité University (CRESS), Sorbonne Paris Nord University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), National Conservatory of Arts and Crafts (Cnam), Bobigny, France
| | - Benjamin Allès
- Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-Paris Cité University (CRESS), Sorbonne Paris Nord University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), National Conservatory of Arts and Crafts (Cnam), Bobigny, France
| | - Joséphine Brunin
- Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-Paris Cité University (CRESS), Sorbonne Paris Nord University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), National Conservatory of Arts and Crafts (Cnam), Bobigny, France.,French Environment and Energy Management Agency (ADEME), Angers, France
| | - Hélène Fouillet
- Physiology of Nutrition and Ingestive Behavior (UMR PNCA), Paris-Saclay University, AgroParisTech, National Research Institute for Agriculture, Food and the Environment (INRAE), Paris, France
| | - Alison Dussiot
- Physiology of Nutrition and Ingestive Behavior (UMR PNCA), Paris-Saclay University, AgroParisTech, National Research Institute for Agriculture, Food and the Environment (INRAE), Paris, France
| | - François Mariotti
- Physiology of Nutrition and Ingestive Behavior (UMR PNCA), Paris-Saclay University, AgroParisTech, National Research Institute for Agriculture, Food and the Environment (INRAE), Paris, France
| | | | - Florine Berthy
- Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-Paris Cité University (CRESS), Sorbonne Paris Nord University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), National Conservatory of Arts and Crafts (Cnam), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-Paris Cité University (CRESS), Sorbonne Paris Nord University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), National Conservatory of Arts and Crafts (Cnam), Bobigny, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-Paris Cité University (CRESS), Sorbonne Paris Nord University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), National Conservatory of Arts and Crafts (Cnam), Bobigny, France.,Department of Public Health, Avicenne Hospital, Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-Paris Cité University (CRESS), Sorbonne Paris Nord University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), National Conservatory of Arts and Crafts (Cnam), Bobigny, France.,Department of Public Health, Avicenne Hospital, Bobigny, France
| | - Denis Lairon
- Cardiovascular and Nutrition Research Center (C2VN), Aix-Marseille University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), Marseille, France
| | - Carine Barbier
- International Centre for Research on the Environment and Development (UMR CIRED), National Center for Scientific Research (CNRS), Montpellier, France
| | | | | | - Julia Baudry
- Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-Paris Cité University (CRESS), Sorbonne Paris Nord University, National Institute of Health and Medical Research (Inserm), National Research Institute for Agriculture, Food and the Environment (INRAE), National Conservatory of Arts and Crafts (Cnam), Bobigny, France
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Elliott PS, Kharaty SS, Phillips CM. Plant-Based Diets and Lipid, Lipoprotein, and Inflammatory Biomarkers of Cardiovascular Disease: A Review of Observational and Interventional Studies. Nutrients 2022; 14:nu14245371. [PMID: 36558530 PMCID: PMC9787709 DOI: 10.3390/nu14245371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Plant-based diets (PBDs) are becoming increasingly popular. Thus far, the literature has focused on their association with lipid profiles, with less investigation of lipoprotein and inflammatory profiles. Because pro-atherogenic lipid, lipoprotein, and inflammatory processes may facilitate the development of atherosclerosis, understanding the relation between PBDs and these processes is important to inform risk mitigation strategies. Therefore, the objective of this paper was to review the literature on PBDs and lipid, lipoprotein, and inflammatory biomarkers of cardiovascular disease (CVD). A structured literature search was performed, retrieving 752 records, of which 43 articles were included. Plant-based diets generally associated with favourable lipid and lipoprotein profiles, characterised by decreased total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B concentrations, and less low-grade inflammation, characterised by decreased C-reactive protein concentrations. Effect sizes from PBD interventions were greatest compared to habitual dietary patterns, and for non-low-fat vegan and tightly controlled dietary interventions. Associations between PBD indices and the reviewed biomarkers were less consistent. Findings are discussed with reference to the literature on PBDs and PBD indices and CVD risk, the associations between specific plant food groups and CVD outcomes and the reviewed biomarker outcomes, and the potential mechanisms underpinning associations between PBDs and reduced CVD risk.
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Affiliation(s)
- Patrick S. Elliott
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, 4 Dublin, Ireland
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, 4 Dublin, Ireland
| | - Soraeya S. Kharaty
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, 4 Dublin, Ireland
| | - Catherine M. Phillips
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, 4 Dublin, Ireland
- Correspondence:
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Kashyap A, Mackay A, Carter B, Fyfe CL, Johnstone AM, Myint PK. Investigating the Effectiveness of Very Low-Calorie Diets and Low-Fat Vegan Diets on Weight and Glycemic Markers in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients 2022; 14. [PMID: 36432557 DOI: 10.3390/nu14224870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 11/19/2022] Open
Abstract
Caloric restriction and vegan diets have demonstrated protective effects for diabetes, however their role in improving clinically relevant outcomes has not been summarized. Our aim was to evaluate the evidence for low-calorie diets (VLCD) and vegan diets on weight and glycemic control in the management of patients with Type 2 Diabetes. Database searches were conducted using Cochrane Library, MEDLINE (Ovid) and Embase. Systematic Review Registration: CRD42022310299. Methodological quality of studies was assessed using Cochrane RoB Tool for RCTs, Cochrane ROBINS-I RoB Tool for non-RCTs and NIH Quality Assessment tool for other studies. Sixteen studies with a total of 834 individuals were included and assessed to have a moderate to high risk of bias. Statistically significant changes in weight, BMI, and HbA1c were not observed in vegan diet cohorts. However, LDL cholesterol was significantly decreased by vegan diet. VLCDs significantly improved glycaemic control, with reductions in fasting glucose, pooled mean difference (MD) -1.51 mmol/L (95% CI -2.89, -0.13; p = 0.03; 2 studies) and HbA1c, pooled MD -0.66% (95% CI -1.28, -0.03; p = 0.04; 3 studies) compared to non-dietary therapy. Both diets suggested a trend towards improved weight loss and anthropometric markers vs. control. VLCD diet intervention is associated with improvement in glycaemia control in patients with Type 2 Diabetes.
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Attini R, Leone F, Chatrenet A, Longhitano E, Casula V, Tomasi Cont A, Zaccaria G, Dalmasso E, Manzione AM, Masturzo B, Torreggiani M, Revelli A, Cabiddu G, Piccoli GB. Plant-Based Diets Improve Maternal-Fetal Outcomes in CKD Pregnancies. Nutrients 2022; 14. [PMID: 36235855 DOI: 10.3390/nu14194203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/01/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Reducing protein intake in patients with chronic kidney disease (CKD) limits glomerular stress induced by hyperfiltration and can prevent the progression of kidney disease; data in pregnancy are limited. The aim of this study is to analyze the results obtained in CKD patients who followed a plant-based moderately protein-restricted diet during pregnancy in comparison with a propensity-score-matched cohort of CKD pregnancies on unrestricted diets. A total of 52 CKD pregnancies followed up with a protein-restricted plant-based diet (Torino, Italy) were matched with a propensity score based on kidney function and proteinuria with CKD pregnancies with unrestricted protein intake (Cagliari Italy). Outcomes included preterm (<37 weeks) and very preterm (<34 weeks) delivery and giving birth to a small-for-gestational-age baby. The median age in our cohort was 34 years, 63.46% of women were primiparous, and the median body mass index (BMI) was 23.15 kg/m2 with 13.46% of obese subjects. No statistical differences were found between women on a plant-based diet and women who were not in terms of age, parity, BMI, obesity, CKD stage, timing of referral, or cause of CKD. No differences were found between the two groups regarding the week of delivery. However, the combined negative outcome (birth before 37 completed gestational weeks or birth-weight centile <10) occurred less frequently in women following the diet than in women in the control group (61.54% versus 80.77%; p = 0.03). The lower risk was confirmed in a multivariable analysis adjusted for renal function and proteinuria (OR: 0.260 [Q1:0.093-Q3:0.724]; p = 0.010), in which the increase in proteinuria from the first to the last check-up before delivery was lower in patients on plant-based diets (median from 0.80 to 1.87 g/24 h; p: ns) than in controls (0.63 to 2.39 g/24 h p <0.0001). Plant-based, moderately protein-restricted diets in pregnancy in patients with CKD are associated with a lower risk of preterm delivery and small-for-gestational-age babies; the effect may be mediated by better stabilization of proteinuria.
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Baleato CL, Ferguson JJA, Oldmeadow C, Mishra GD, Garg ML. Plant-Based Dietary Patterns versus Meat Consumption and Prevalence of Impaired Glucose Intolerance and Diabetes Mellitus: A Cross-Sectional Study in Australian Women. Nutrients 2022; 14:nu14194152. [PMID: 36235806 PMCID: PMC9573342 DOI: 10.3390/nu14194152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/04/2022] Open
Abstract
This study aimed to compare the prevalence of impaired glucose tolerance (IGT) and diabetes mellitus (DM) among Australian women following plant-based diets (PBD) compared to regular meat eaters. A cross sectional analysis of the mid-aged cohort (1946−1951) of the Australian Longitudinal Study on Women’s Health was conducted on completers of Survey 7 in 2013 with complete FFQ data available (n = 9102). Dietary patterns were categorized as PBD (vegan, lacto-ovo vegetarian, pesco-vegetarian, semi-vegetarian) and regular meat eaters. Meat eaters were further categorized into high and low consumption and outcomes included self-reported prevalence of IGT and DM. Participants were identified as regular meat eaters (n = 8937) and PBD (n = 175). Prevalence of IGT was lower in PBD (0−1.2%) compared to regular meat eaters (9.1%). Consolidation of PBD to a single group (vegetarians) indicated a lower prevalence of DM in vegetarians compared to regular meat eaters (3.9% vs. 9.1%). Women consuming meat daily/multiple times per day had significantly higher odds of IGT (OR 1.5, 95%CI 1.1 to 2.1, p = 0.02). Individuals consuming processed meat daily/multiple times per day had significantly higher odds of DM compared to those consuming less than daily (Odds ratio (OR) 1.7, 95% confidence interval (CI) 1.3 to 2.3, p < 0.0001). After adjustment for covariates, statistical significance was lost largely due to the addition of BMI to the model. Prevalence of IGT and DM were lower in women following PBD and higher in high consumers of meat and processed meat. The relationship between meat consumption and IGT/diabetes status appears to be mediated, at least in part, by an increase in body mass index (BMI). Future studies are warranted to investigate the mechanisms and other lifestyle factors underpinning the association between high meat consumption and increased risk of IGT and DM.
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Affiliation(s)
- Courtney L. Baleato
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Jessica J. A. Ferguson
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
- Food & Nutrition Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Gita D. Mishra
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Manohar L. Garg
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
- Food & Nutrition Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Correspondence: ; Tel.: +61-2-49215647
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Kim J, Giovannucci E. Healthful Plant-Based Diet and Incidence of Type 2 Diabetes in Asian Population. Nutrients 2022; 14:3078. [PMID: 35893932 DOI: 10.3390/nu14153078] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
Plant-based diets have been suggested to be beneficial for type 2 diabetes (T2D). However, studies investigating the association between the healthiness of a plant-based diet and T2D risk are limited. This study explored the prospective association between scores from three different plant-based diet indices and risk of T2D and investigated whether associations differ by demographic and lifestyle factors in the Korean population. Data were derived from the Korean Genome and Epidemiology Study (KoGES), a prospective cohort study initiated between 2001 and 2002. Dietary intakes were assessed using a validated food frequency questionnaire. Scores for three plant-based diet indices (overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI)) were measured. A total of 7363 Korean adults aged 40–69 years without T2D and related chronic diseases at baseline were included. Incident T2D was defined as elevated plasma glucose (≥126 mg/dL), self-report of a doctor’s diagnosis of T2D, or use of oral hypoglycemic drug. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for T2D risk. During a follow-up period of 14 years, 977 participants developed T2D. A 10-point higher score in hPDI was associated with a 14% lower risk of T2D (HR: 0.86, 95% CI, 0.77–0.95), adjusting for potential confounders. In subgroup analysis, inverse associations between hPDI and T2D risk were stronger in participants with a family history of T2D (HR: 0.58, 95% CI, 0.44 0.76) or history of hypertension (HR: 0.73, 95% CI, 0.60 0.89) than those without a family history of T2D (p interaction = 0.01) or history of hypertension (p interaction = 0.04). Considering the quality of the plant foods may be important for the prevention of T2D in the Korean population, which habitually consumes diets rich in plant foods.
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Bhupathiraju SN, Sawicki CM, Goon S, Gujral UP, Hu FB, Kandula NR, Kanaya AM. A healthy plant-based diet is favorably associated with cardiometabolic risk factors among participants of South Asian ancestry. Am J Clin Nutr 2022; 116:1078-1090. [PMID: 35731596 PMCID: PMC9755998 DOI: 10.1093/ajcn/nqac174] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/10/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Plant-based diets are recommended for chronic disease prevention, yet there has been little focus on plant-based diet quality among participants of South Asian ancestry who consume a predominantly plant-based diet. OBJECTIVES We evaluated cross-sectional and prospective associations between plant-based diet quality and cardiometabolic risks among participants of South Asian ancestry who are living in the United States. METHODS We included 891 participants of South Asian ancestry who completed the baseline visit in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. The prospective analysis included 735 participants who completed exam 2 (∼5 years after baseline). The plant-based diet quality was assessed using 3 indices: an overall plant-based diet index (PDI) that summarizes the consumption of plant foods, a healthy PDI (hPDI) that measures consumption of healthy plant foods, and an unhealthy PDI (uPDI) that reflects consumption of less healthy plant foods. RESULTS At baseline, the PDI score was inversely associated with fasting glucose. We observed inverse associations between PDI and hPDI scores and HOMA-IR, LDL cholesterol, weight, and BMI (all P values < 0.05). Higher scores on the hPDI, but not PDI, were associated with lower glycated hemoglobin, higher adiponectin, a smaller visceral fat area, and a smaller pericardial fat volume. Each 5-unit higher hPDI score was associated with lower likelihoods of fatty liver (OR: 0.76; 95% CI: 0.64, 0.90) and obesity (OR: 0.88; 95% CI: 0.80, 0.97). There were no associations between uPDI scores and cardiometabolic risks. Prospectively, after covariate adjustment for baseline values, each 5-unit higher hPDI score was associated with an 18% lower risk of incident type 2 diabetes (OR: 0.82; 95% CI: 0.67, 1.00). CONCLUSIONS A higher intake of healthful plant-based foods was associated with a favorable cardiometabolic risk profile. Dietary recommendations to lower chronic disease risks among participants of South Asian ancestry should focus on the quality of plant-based foods.
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Affiliation(s)
| | - Caleigh M Sawicki
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Shatabdi Goon
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Unjali P Gujral
- Hubert Department of Global Health, Emory Global Diabetes Research Center, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Namratha R Kandula
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alka M Kanaya
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Gastaldello A, Giampieri F, Quiles JL, Navarro-Hortal MD, Aparicio S, García Villena E, Tutusaus Pifarre K, De Giuseppe R, Grosso G, Cianciosi D, Forbes-Hernández TY, Nabavi SM, Battino M. Adherence to the Mediterranean-Style Eating Pattern and Macular Degeneration: A Systematic Review of Observational Studies. Nutrients 2022; 14:nu14102028. [PMID: 35631175 PMCID: PMC9144566 DOI: 10.3390/nu14102028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/01/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
Age-related macular degeneration (AMD) is a serious degenerative disease affecting the eyes, and is the main cause of severe vision loss among people >55 years of age in developed countries. Its onset and progression have been associated with several genetic and lifestyle factors, with diet appearing to play a pivotal role in the latter. In particular, dietary eating patterns rich in plant foods have been shown to lower the risk of developing the disease, and to decrease the odds of progressing to more advanced stages in individuals already burdened with early AMD. We systematically reviewed the literature to analyse the relationship between the adherence to a Mediterranean diet, a mainly plant-based dietary pattern, and the onset/progression of AMD. Eight human observational studies were analysed. Despite some differences, they consistently indicate that higher adherence to a Mediterranean eating pattern lowers the odds of developing AMD and decreases the risk of progression to more advanced stages of the disease, establishing the way for preventative measures emphasizing dietary patterns rich in plant-foods.
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Affiliation(s)
- Annalisa Gastaldello
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
| | - Francesca Giampieri
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah 80200, Saudi Arabia
- Correspondence: (F.G.); (M.B.)
| | - José L. Quiles
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Centre, University of Granada, 18100 Granada, Spain; (M.D.N.-H.); (T.Y.F.-H.)
| | - María D. Navarro-Hortal
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Centre, University of Granada, 18100 Granada, Spain; (M.D.N.-H.); (T.Y.F.-H.)
| | - Silvia Aparicio
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Faculdade de Ciências Sociais e Humanas, Universidade Internacional do Cuanza Bairro Kaluanda, Cuito EN 250, Bié, Angola
| | - Eduardo García Villena
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department de Salud, Universidad Internacional Iberoamericana Campeche, Campeche 24560, Mexico
| | - Kilian Tutusaus Pifarre
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department de Salud, Universidad Internacional Iberoamericana Campeche, Campeche 24560, Mexico
| | - Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy;
| | - Danila Cianciosi
- Department of Clinical Sciences, Polytechnic University of Marche, 60131 Ancona, Italy;
| | - Tamara Y. Forbes-Hernández
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Centre, University of Granada, 18100 Granada, Spain; (M.D.N.-H.); (T.Y.F.-H.)
| | - Seyed M. Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran;
| | - Maurizio Battino
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department of Clinical Sciences, Polytechnic University of Marche, 60131 Ancona, Italy;
- International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu University, Zhenjiang 212013, China
- Correspondence: (F.G.); (M.B.)
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Kluczkovski A, Menezes CA, da Silva JT, Bastos L, Lait R, Cook J, Cruz B, Cerqueira B, Lago RMRS, Gomes AN, Ladeia AMT, Schmidt Rivera X, Vianna N, Reynolds CJ, Oliveira RR, Bridle SL. An Environmental and Nutritional Evaluation of School Food Menus in Bahia, Brazil That Contribute to Local Public Policy to Promote Sustainability. Nutrients 2022; 14:1519. [PMID: 35406132 DOI: 10.3390/nu14071519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 02/05/2023] Open
Abstract
Aimed at improving the quality of school meals, the Sustainable School Program (SSP) implemented low-carbon meals, twice a week, in 155 schools of 4 municipalities, reaching more than 32,000 students. This study evaluated the environmental impact and nutritional viability of this intervention for this population. The 15 most repeated meals from the conventional and sustainable menus were selected, and we considered the school age group and number of meals served per student/day. Nutritional information was calculated using validated food composition tables, nutritional adequacy was assessed using National School Feeding Program (PNAE) requirements, the level of processing was considered using NOVA classification, and greenhouse gas emissions (GHGE) were estimated using food life cycle assessment (LCA) validated data. We found both conventional and sustainable food menus are equivalent, in terms of nutrients, except for calcium, iron, and magnesium. Sustainable food menus were cholesterol-free. However, there was a reduction of up to 17% in GHGE, depending on the school age group analysed. Considering the greater energy efficiency and lower environmental impact of these food menus, the SSP, therefore, demonstrates that a substantial reduction in climate impact is feasible, successful, and can be an inspiration to other regions globally.
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Abstract
Interest in plant-based diets and vegetarianism is increasing worldwide, however, a concern for total vegetarians is vitamin B12 (B12) deficiency. We conducted a systematic review to investigate non-animal food sources of B12. Databases were PubMed, LILACS, Cochrane, Embase and Google Scholar, up to September 9, 2020. Quality of the eligible studies were assessed. We identified 25 studies which assessed B12 content in seaweeds, mushrooms, plants and fermented foods. Initial studies were microbiological bioassay, ELISA and HPLC. In the last decade, more sensitive method for real B12 determination was used, the liquid chromatography-electrospray ionization tandem mass spectrometry chromatograms. Real B12 content varied from mean (SD) mcg/portion size of seaweed hijiki 3 × 10-3/7 g to nori 1.03 - 2.68/sheet; mushroom white button cap 2 × 10-3(7 × 10-4)/20 g dry weight (dw) to shiitake 0.79(0.67)-1.12 (0.78)/20 g dw; and fermented foods from soy yogurt 20/cup. It is possible that daily recommendations for B12 can be met by a varied diet containing non-animal B12 food sources. Future research should consider different methods of storage, preparation, fermented foods and standardization of the production of certain foods.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2053057.
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Affiliation(s)
- Beatriz Marques de Brito
- Department of Preventive Medicine, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Vinícius de Menezes Campos
- Department of Preventive Medicine, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Félix Jesus Neves
- Department of Preventive Medicine, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Luiz Roberto Ramos
- Department of Preventive Medicine, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Luciana Yuki Tomita
- Department of Preventive Medicine, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
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Kim H, Yu B, Li X, Wong KE, Boerwinkle E, Seidelmann SB, Levey AS, Rhee EP, Coresh J, Rebholz CM. Serum metabolomic signatures of plant-based diets and incident chronic kidney disease. Am J Clin Nutr 2022; 116:151-164. [PMID: 35218183 PMCID: PMC9257476 DOI: 10.1093/ajcn/nqac054] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/24/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Greater adherence to plant-based diets is associated with a lower risk of incident chronic kidney disease (CKD). Metabolomics can help identify blood biomarkers of plant-based diets and enhance understanding of underlying mechanisms. OBJECTIVES Using untargeted metabolomics, we aimed to identify metabolites associated with 4 plant-based diet indices (PDIs) (overall PDI, provegetarian diet, healthful PDI, and unhealthful PDI) and incident CKD in 2 subgroups within the Atherosclerosis Risk in Communities study. METHODS We calculated 4 PDIs based on participants' responses on an FFQ. We used multivariable linear regression to examine the association between 4 PDIs and 374 individual metabolites, adjusting for confounders. We used Cox proportional hazards regression to evaluate associations between PDI-related metabolites and incident CKD. Estimates were meta-analyzed across 2 subgroups (n1 = 1762; n2 = 1960). We calculated C-statistics to assess whether metabolites improved the prediction of those in the highest quintile compared to the lower 4 quintiles of PDIs, and whether PDI- and CKD-related metabolites predicted incident CKD beyond the CKD prediction model. RESULTS We identified 82 significant PDI-metabolite associations (overall PDI = 27; provegetarian = 17; healthful PDI = 20; unhealthful PDI = 18); 11 metabolites overlapped across the overall PDI, provegetarian diet, and healthful PDI. The addition of metabolites improved prediction of those in the highest quintile as opposed to the lower 4 quintiles of PDIs compared with participant characteristics alone (range of differences in C-statistics = 0.026-0.104; P value ≤ 0.001 for all tests). Six PDI-related metabolites (glycerate, 1,5-anhydroglucitol, γ-glutamylalanine, γ-glutamylglutamate, γ-glutamylleucine, γ-glutamylvaline), involved in glycolysis, gluconeogenesis, pyruvate metabolism, and γ-glutamyl peptide metabolism, were significantly associated with incident CKD and improved prediction of incident CKD beyond the CKD prediction model (difference in C-statistics for 6 metabolites = 0.005; P value = 0.006). CONCLUSIONS In a community-based study of US adults, we identified metabolites that were related to plant-based diets and predicted incident CKD. These metabolites highlight pathways through which plant-based diets are associated with incident CKD.
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Affiliation(s)
- Hyunju Kim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Bing Yu
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Sciences Center at Houston School of Public Health, Houston, TX, USA
| | - Xin Li
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | | | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Sciences Center at Houston School of Public Health, Houston, TX, USA
| | - Sara B Seidelmann
- College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Andrew S Levey
- Division of Nephrology, Tufts Medical Center, Boston, MA, USA
| | - Eugene P Rhee
- Nephrology Division and Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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43
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Stanford J, Zuck M, Stefoska-Needham A, Charlton K, Lambert K. Acceptability of Plant-Based Diets for People with Chronic Kidney Disease: Perspectives of Renal Dietitians. Nutrients 2022; 14:216. [PMID: 35011091 DOI: 10.3390/nu14010216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/24/2021] [Accepted: 01/01/2022] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study was to explore the perspective of renal dietitians regarding plant-based diets for chronic kidney disease (CKD) management and evaluate the acceptability of a hypothetical plant-based dietary prescription aiming for the consumption of 30 unique plant foods per week. This study used an exploratory mixed methods design. Forty-six renal dietitians participated in either an online survey (n = 35) or an in-depth interview (n = 11). Dietitians perceived that plant-based diets could address multiple clinical concerns relevant to CKD. Forty percent of survey respondents reported the hypothetical dietary prescription was realistic for people with CKD, 34.3% were unsure, and 25.7% perceived it as unrealistic. Strengths of the hypothetical prescription included shifting the focus to whole foods and using practical resources like recipes. Limited staffing, time, and follow-up opportunities with patients, as well as differing nutrition philosophies were the most commonly reported challenges to implementation; while a supportive multidisciplinary team was identified as an important enabler. To increase patient acceptance of plant-based dietary approaches, education about plant food benefits was recommended, as was implementing small, incremental dietary changes. Successful implementation of plant-based diets is perceived to require frequent patient contact and ongoing education and support by a dietitian. Buy-in from the multidisciplinary team was also considered imperative.
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Njike VY, Treu JA, Kela GCM, Ayettey RG, Comerford BP, Siddiqui WT. Egg Consumption in the Context of Plant-Based Diets and Cardiometabolic Risk Factors in Adults at Risk of Type 2 Diabetes. J Nutr 2021; 151:3651-3660. [PMID: 34494112 DOI: 10.1093/jn/nxab283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/27/2021] [Accepted: 08/04/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Plant-based diets (PBDs) are typically recommended to those at risk of type 2 diabetes mellitus (T2DM). OBJECTIVES We examined how including eggs, compared with excluding them from PBDs, affected cardiometabolic risk factors in adults at risk of T2DM. METHODS This was a randomized, controlled, single-blind, crossover trial of 35 adults (mean age: 60.7 y; 25 women, 10 men) at risk of T2DM assigned to 1 of 2 sequence permutations of 2 dietary treatments (plant-based plus eggs, and exclusively plant-based), with a 4-wk washout period. A dietitian counseled participants to exclude or include 2 eggs daily in the context of PBDs for a 6-wk interval. Our primary outcome measure was endothelial function (EF) measured as flow-mediated dilatation. Secondary outcome measures included lipid profile, blood pressure, insulin sensitivity, anthropometry, and dietary intake. Data were analyzed using generalized linear models. RESULTS Compared with egg exclusion, egg inclusion in the context of PBDs did not adversely affect EF (-1.7% ± 6.5% compared with -1.8% ± 7.5%; P = 0.9805). Likewise, egg inclusion, compared with egg exclusion, did not adversely affect (P = 0.1096-0.9781) lipid profile, blood pressure, insulin sensitivity, or anthropometry. Egg inclusion, compared with egg exclusion, improved reported intakes of selenium (23.1 ± 30.3 μg/d compared with 2.3 ± 34.9 μg/d; P = 0.0124) and choline (172.0 ± 96.0 mg/d compared with -3.4 ± 68.1 mg/d; P < 0.0001). CONCLUSIONS Consuming 2 eggs daily in the context of PBDs does not adversely affect cardiometabolic risk factors among adults at risk of T2DM. Eggs could be used as an adjuvant to enhance PBDs that are typically recommended for those at risk of T2DM.This trial was registered at clinicaltrials.gov as NCT04316429.
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Affiliation(s)
- Valentine Y Njike
- Yale-Griffin Prevention Research Center, Derby, CT, USA.,Griffin Hospital Medical Education, Derby, CT, USA
| | - Judith A Treu
- Yale-Griffin Prevention Research Center, Derby, CT, USA
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Song S, Lee K, Park S, Shin N, Kim H, Kim J. Association between Unhealthful Plant-Based Diets and Possible Risk of Dyslipidemia. Nutrients 2021; 13:nu13124334. [PMID: 34959886 PMCID: PMC8706499 DOI: 10.3390/nu13124334] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 02/06/2023] Open
Abstract
The relationship between the various types of diets derived from plants and vulnerability of dyslipidemia has rarely been investigated, and limited data exist in Asians whose dietary pattern is fairly different from that of the Western population. We aim to analyze the relationship between three plant-based diet indices (PDI) and the risk of dyslipidemia. Participants included 173,209 Korean adults who were aged ≥40 years from the Korean Genome and Epidemiology Study_Health Examination (2004–2013). A food frequency questionnaire (FFQ) was used to assess dietary intake. Three PDI were quantified for the study: overall PDI, healthful PDI (hPDI), and unhealthful PDI (uPDI). Among the 147,945 included, 48,166 (32.6%) of participants had dyslipidemia. Great adherence to uPDI was related with 15% greater odds of having dyslipidemia (OR: 1.15; 95% CI: 1.11–1.20, p-trend < 0.0001). No significant association was observed between PDI, hPDI, and dyslipidemia. The association between uPDI and dyslipidemia was significantly stronger among participants aged ≥55 years when compared to participants aged <55 years (p-value for interaction = 0.001). The quality of plant foods is vital in preventing dyslipidemia among people consuming high plant-based food diets.
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Affiliation(s)
- Sujin Song
- Department of Food and Nutrition, Hannam University, Daejeon 34054, Korea;
| | - Kyueun Lee
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea; (K.L.); (N.S.)
| | - Soim Park
- Department of Internal Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA;
| | - Nara Shin
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea; (K.L.); (N.S.)
| | - Hyunju Kim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA;
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Jihye Kim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea; (K.L.); (N.S.)
- Correspondence: ; Tel.: +82-31-201-3497
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46
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Quek J, Lim G, Lim WH, Ng CH, So WZ, Toh J, Pan XH, Chin YH, Muthiah MD, Chan SP, Foo RSY, Yip J, Neelakantan N, Chong MFF, Loh PH, Chew NWS. The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies. Front Cardiovasc Med 2021; 8:756810. [PMID: 34805312 PMCID: PMC8604150 DOI: 10.3389/fcvm.2021.756810] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/24/2021] [Indexed: 12/17/2022] Open
Abstract
Background: The association between plant-based diets and cardiovascular disease (CVD) remains poorly characterized. Given that diet represents an important and a modifiable risk factor, this study aimed to assess (1) the relationships between the impact of adherence to plant-based diets on cardiovascular mortality, incident CVD, and stroke; (2) if associations differed by adherence to healthful and less healthful plant-based diets. Methods and Findings: MEDLINE and EMBASE databases were searched up to May 2021. Studies assessing CVD outcomes with relation to plant-based dietary patterns or according to plant-based dietary indices (PDI) were included. A meta-analysis of hazard ratios (HR) was conducted using DerSimonian and Laird random effects model. Thirteen studies involving 410,085 participants were included. Greater adherence to an overall plant-based dietary pattern was significantly associated with a lower risk of cardiovascular mortality (pooled HR: 0.92, 95% CI: 0.86–0.99 p = 0.0193, I2 = 88.5%, N = 124,501) and a lower risk of CVD incidence (pooled HR: 0.90, 95% CI: 0.82–0.98, p = 0.0173, I2 = 87.2%, N = 323,854). Among the studies that used PDI, unhealthful plant-based diets were associated with increased risk of cardiovascular mortality (pooled HR: 1.05, 95% CI: 1.01–1.09, p = 0.0123, I2 = 0.00%, N = 18,966), but not CVD incidence. Conversely, healthful plant-based diets were associated with decreased CVD incidence (pooled HR: 0.87, 95% CI: 0.80–0.95, p = 0.0011, I2 = 57.5%, N = 71,301), but not mortality. Vegetarians also had significantly lower CVD incidence (HR: 0.81, 95% CI: 0.72–0.91, p = 0.0004, I2 = 22.2%, N = 16,254), but similar CVD mortality or stroke risk when compared to the meat-eaters. Conclusion: To date, this comprehensive study examines the effects of a plant-based diet on major clinical endpoints using more holistic PDIs. These findings highlight the favorable role of healthful plant-based foods in reducing cardiovascular mortality and CVD.
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Affiliation(s)
- Jingxuan Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Grace Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Zheng So
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jonathan Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xin Hui Pan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mark D Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.,National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
| | - Siew Pang Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Roger S Y Foo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - James Yip
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Mary F F Chong
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Poay Huan Loh
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
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Craig WJ, Mangels AR, Fresán U, Marsh K, Miles FL, Saunders AV, Haddad EH, Heskey CE, Johnston P, Larson-Meyer E, Orlich M. The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals. Nutrients 2021; 13:4144. [PMID: 34836399 PMCID: PMC8623061 DOI: 10.3390/nu13114144] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 12/13/2022] Open
Abstract
Plant-based diets, defined here as including both vegan and lacto-ovo-vegetarian diets, are growing in popularity throughout the Western world for various reasons, including concerns for human health and the health of the planet. Plant-based diets are more environmentally sustainable than meat-based diets and have a reduced environmental impact, including producing lower levels of greenhouse gas emissions. Dietary guidelines are normally formulated to enhance the health of society, reduce the risk of chronic diseases, and prevent nutritional deficiencies. We reviewed the scientific data on plant-based diets to summarize their preventative and therapeutic role in cardiovascular disease, cancer, diabetes, obesity, and osteoporosis. Consuming plant-based diets is safe and effective for all stages of the life cycle, from pregnancy and lactation, to childhood, to old age. Plant-based diets, which are high in fiber and polyphenolics, are also associated with a diverse gut microbiota, producing metabolites that have anti-inflammatory functions that may help manage disease processes. Concerns about the adequate intake of a number of nutrients, including vitamin B12, calcium, vitamin D, iron, zinc, and omega-3 fats, are discussed. The use of fortified foods and/or supplements as well as appropriate food choices are outlined for each nutrient. Finally, guidelines are suggested for health professionals working with clients consuming plant-based diets.
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Affiliation(s)
- Winston J. Craig
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | | | - Ujué Fresán
- eHealth Group, Instituto de Salud Global Barcelona (ISGlobal), 08036 Barcelona, Spain;
| | - Kate Marsh
- Private Practice, Chatswood, NSW 2067, Australia;
| | - Fayth L. Miles
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Angela V. Saunders
- Nutrition Insights, Sanitarium Health Food Company, Berkeley Vale, NSW 2261, Australia;
| | - Ella H. Haddad
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Celine E. Heskey
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Patricia Johnston
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Enette Larson-Meyer
- Human Nutrition, Foods, and Exercise Virginia Tech, Blacksburg, VA 24061, USA;
| | - Michael Orlich
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
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Ma X, Tan H, Hu M, He S, Zou L, Pan H. The impact of plant-based diets on female bone mineral density: Evidence based on seventeen studies. Medicine (Baltimore) 2021; 100:e27480. [PMID: 34797275 PMCID: PMC8601298 DOI: 10.1097/md.0000000000027480] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 09/17/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND An increase in awareness of plant-based diets has brought forth numerous studies on bone mineral density (BMD). The present systematic review and meta-analysis was designed to compare the effect between plant-based diets and omnivores on female BMD. METHODS We searched the Cochrane Library, PubMed, EMBASE, and Web of Science and up to July 1, 2020. Mean difference (MD) with its 95% confidence interval (CI) was estimated to compare the outcomes of the groups. We compared BMD at the lumbar spine, femoral neck and whole body respectively between plant-based diets and omnivores. In addition, we performed subgroup analyses according to different clinical characteristics for further exploration. Two reviewers assessed trial quality and extracted data independently. All statistical analyses were performed using standard statistical procedures provided in Review Manager 5.2. RESULTS A total of 17 cross-sectional studies including 13,888 patients were identified for the present meta-analysis. Our pooled result indicated that population with plant-based diets had lower BMD than omnivores at the lumbar spine (MD -0.03; 95% CI -0.04 to -0.02; P < .0001), femoral neck (MD -0.04; 95% CI -0.05 to -0.03; P < .00001) and whole body (MD -0.04; 95% CI -0.06 to -0.01; P = .01), respectively. Further exploration indicated that especially females with plant-based diets experienced significantly lower BMD at lumbar spine (MD -0.03; 95% CI -0.04 to -0.02; 3173 pts), femoral neck (MD -0.04; 95% CI -0.05 to -0.03; 10,656 pts) and whole body (MD -0.05; 95% CI -0.10 to -0.00; P = .04). In addition, we performed subgroup analyses and found lower BMD at lumbar spine and femoral neck in both vegetarians and vegans. CONCLUSIONS The present meta-analysis indicated that plant-based diets may be correlated with lower BMD of women when compared with omnivore population. However, this does not diminish the fact that a plant-based diet can be a harmful option to the overall bone health of population and more prospective researches are needed to clear the impact of plant-based diets on bone health.
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Affiliation(s)
- Xingfa Ma
- School of Sports and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoyin Tan
- School of Sports and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mingjun Hu
- School of Sports and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
| | | | - Lijuan Zou
- School of Sports and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huashan Pan
- GuangDong Food and Drug Vocational College Science and Technology Division, Guangzhou, China
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Mocanu CA, Simionescu TP, Mocanu AE, Garneata L. Plant-Based versus Animal-Based Low Protein Diets in the Management of Chronic Kidney Disease. Nutrients 2021; 13:nu13113721. [PMID: 34835976 PMCID: PMC8621419 DOI: 10.3390/nu13113721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 12/14/2022] Open
Abstract
Recent data reiterate low-protein diets (LPDs) as cornerstones in the conservative management of chronic kidney disease (CKD). The reduction in proteinuria, better blood pressure control and the reduction in the rate of decline in kidney function with LPDs were reported, both in non-diabetics and diabetics patients. Supplemented, vegetarian, very-low-protein diets (sVLPD, 0.3 g/kg-day) could postpone kidney replacement therapy (KRT) initiation, mainly through the better control of metabolic disorders of advanced CKD in non-diabetic patients. Plant-based diets could ameliorate gut microbiota and appear to be superior to mixed hypoproteic diets in treating advanced CKD: better control of nitrogen balance, acid-base metabolism and bone mineral disorders. Vegetarian diets generate fewer uremic toxins and reduce salt intake and acid overload. At the same time, they can improve lipid metabolism, providing a high ratio of unsaturated to saturated fatty acids, as well as insulin resistance.
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Affiliation(s)
- Carmen-Antonia Mocanu
- Department of Internal Medicine and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Nephrology, “Dr. Carol Davila” Teaching Hospital of Nephrology, 4 Calea Grivitei, Sector 1, 010731 Bucharest, Romania; (T.P.S.); (A.E.M.)
- Correspondence:
| | - Tudor Petrisor Simionescu
- Department of Nephrology, “Dr. Carol Davila” Teaching Hospital of Nephrology, 4 Calea Grivitei, Sector 1, 010731 Bucharest, Romania; (T.P.S.); (A.E.M.)
| | - Andreea Elena Mocanu
- Department of Nephrology, “Dr. Carol Davila” Teaching Hospital of Nephrology, 4 Calea Grivitei, Sector 1, 010731 Bucharest, Romania; (T.P.S.); (A.E.M.)
| | - Liliana Garneata
- Department of Internal Medicine and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Nephrology, “Dr. Carol Davila” Teaching Hospital of Nephrology, 4 Calea Grivitei, Sector 1, 010731 Bucharest, Romania; (T.P.S.); (A.E.M.)
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Laouali N, Shah S, MacDonald CJ, Mahamat-Saleh Y, El Fatouhi D, Mancini F, Fagherazzi G, Boutron-Ruault MC. BMI in the Associations of Plant-Based Diets with Type 2 Diabetes and Hypertension Risks in Women: The E3N Prospective Cohort Study. J Nutr 2021; 151:2731-2740. [PMID: 34236437 DOI: 10.1093/jn/nxab158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/25/2021] [Accepted: 04/29/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Few studies have evaluated the quality of plant-based diets in relation to chronic diseases, and the potential role of BMI is not clearly explored. OBJECTIVES To study the associations between plant-based diet indices and type 2 diabetes (T2D) and hypertension risks, as well as the extent to which the associations were modified and/or mediated by BMI. METHODS The study included 74,522 women from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale prospective cohort [mean (SD): age, 52.94 (6.7) years; BMI, 22.970 (3.328) kg/m2]. Dietary data were collected at baseline (1993) via an FFQ. Overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI) were developed. Multivariable Cox regression models were used to derive HRs and 95% CIs. Effect modification and mediation by BMI were explored. RESULTS There were 3292 (4.64%) incident cases of T2D and 12,504 (27.14%) incident cases of hypertension over ∼20 years of follow-up. In the multivariable model further adjusted for BMI, higher adherence to PDI and hPDI was associated with lower T2D and hypertension risks, with an HR per 1-SD increase (95% CI) of 0.88 (0.85, 0.91) and 0.96 (0.94, 0.98) for PDI and 0.88 (0.85, 0.92) and 0.94 (0.92, 0.95) for hPDI, respectively. uPDI was not associated with T2D [0.98 (0.94, 1.01)], whereas a positive association was observed with hypertension: 1.04 (1.02, 1.06). There was interaction between PDI and uPDI, as well as BMI, on T2D (P-interaction < 0.001) but not on hypertension (P-interaction > 0.05). In addition, BMI mediated 26-59% and 0.2-59% of diet-T2D and diet-hypertension associations, respectively. CONCLUSIONS Differential associations between plant-based diets and T2D and hypertension risks were observed among women in this large prospective study. Only healthier plant foods were associated with lower risks, partly through decreasing BMI. The protocol was registered at clinicaltrials.gov as NCT03285230.
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Affiliation(s)
- Nasser Laouali
- Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP, Villejuif, France.,Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA, USA
| | - Sanam Shah
- Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP, Villejuif, France
| | - Conor-James MacDonald
- Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP, Villejuif, France
| | - Yahya Mahamat-Saleh
- Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP, Villejuif, France
| | - Douae El Fatouhi
- Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP, Villejuif, France
| | - Francesca Mancini
- Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP, Villejuif, France
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Marie-Christine Boutron-Ruault
- Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP, Villejuif, France
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